Looking at early dietetic intervention for patients with oesophago-gastric cancer and how this impacts nutritional outcomes.
Dietitian Recognition Award for Improvement in Patient Care Prize Winner
“Impact of early dietetic intervention on nutritional outcomes for patients with oesophago-gastric cancer in Greater Manchester.”
Ms Hayes explains:
“The aim of our project was to increase contact to early oesophago-gastric (OG) specialist dietitians, reducing current inequalities to a comprehensive nutritional assessment, optimising patients for treatment and improving patients’ experience. The holistic review focused on assessing the patient’s medical history, nutritional status, including anorexia and impact symptoms, functional status and patient wishes related to their current wellbeing. These were delivered in novel, holistic specialist nurse and dietitian led clinics, plus dietetic input to weekly MDT meetings.”
The delivery model of this project included:
- A baseline assessment of all patients with a suspected OG cancer diagnosis within 7-14 days of referral
- After this, a weekly telephone review up to 4 weeks to coincide with “decision to treat”
- From this, onward referrals could then to signposted to local or specialist oncology dietitians
“During the 7-month data collection period, 152 patients were referred to the service with 136 confirmed as an OG cancer diagnosis. At baseline 77% of patients were suffering with unintentional weight loss, with an average loss of 6.8% (>5% weight loss indicative of cancer cachexia), 55% had symptoms of dysphagia and 69% were screened as anorexic.
By four-week follow-up 50% of the cohort achieved weight stability or gain, with average weight loss reducing to 3.7% in those still losing weight, 80% improvement of anorexia scores, resulting in a 28% increase in calorie and 40% increase in protein intakes. There was early identification of tube feed and stent requirements, reducing the number of emergency presentations to A&E owing to obstruction or feeding difficulties.
Why did you choose this project?
“‘I am passionate about nutritional care in patients with gastrointestinal conditions and improving quality and outcomes. When the opportunity arose to lead the implementation of dietetic assessment in the oesophago-gastric cancer pathway I did not hesitate to get involved.
The patient feedback was invariably positive, noting that information was easy to understand, advice given was thorough and the resources were really helpful. Following the project evaluation, we successfully received sustainability to continue early dietetic intervention in OG cancer across all boroughs of Greater Manchester.”
The team worked immensely hard on this project and are passionate about providing a high standard of nutritional care to patients diagnosed with OG cancer. To have this recognised by GUTS UK and Dr Falk Pharma UK is an amazing achievement for us all. Personally, I am grateful to have had the opportunity to be involved in the project and positively impact quality of care and I hope to continue to develop novel services as part of the NHS, which have innovation and quality of patient care at the heart.- Catherine Hayes