Effect of Early and Intensive Telephone or Electronic Nutrition Counselling Delivered to People with Upper Gastrointestinal Cancer on Quality of Life: A Three-Arm Randomised Controlled Trial
Background: Delay in dietetic service provision for upper gastrointestinal cancer exacerbates disease-related malnutrition and consequently increases morbidity and mortality. Dietetic services are usually referral-based and provided face-to-face in inpatient or outpatient settings, which can delay t...
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MDPI AG
2022-08-01
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Series: | Nutrients |
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Online Access: | https://www.mdpi.com/2072-6643/14/15/3234 |
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author | Catherine E. Huggins Lauren Hanna Kate Furness Mary Anne Silvers June Savva Helena Frawley Daniel Croagh Paul Cashin Liang Low Judy Bauer Helen Truby Terry P. Haines |
author_facet | Catherine E. Huggins Lauren Hanna Kate Furness Mary Anne Silvers June Savva Helena Frawley Daniel Croagh Paul Cashin Liang Low Judy Bauer Helen Truby Terry P. Haines |
author_sort | Catherine E. Huggins |
collection | DOAJ |
description | Background: Delay in dietetic service provision for upper gastrointestinal cancer exacerbates disease-related malnutrition and consequently increases morbidity and mortality. Dietetic services are usually referral-based and provided face-to-face in inpatient or outpatient settings, which can delay the commencement of nutrition care. The aim of this study was to provide intensive dietetic intervention close to the time of diagnosis for upper gastrointestinal cancer and assess the effect on quality-adjusted life years. Methods: A three-arm randomised controlled trial of adults newly diagnosed with upper gastrointestinal cancer was performed. A behavioural-based, individually tailored, symptom-directed nutrition intervention was provided in addition to usual care, delivered by a dietitian using a telephone (synchronously) or a mobile application (asynchronously) for 18 weeks, compared with a usual care control group. Data were collected at baseline, three, six, and twelve months post-randomisation. The primary outcome was quality-adjusted life years (EQ-5D-5L quality of life assessment tool). Data were analysed using linear mixed models. Results: One hundred and eleven participants were randomised. Quality-adjusted life years were not different in the intervention groups compared with control (telephone: mean (95% CI) 0.04 (0.43, 2.3), <i>p</i> = 0.998; App: −0.08 (−0.18, 0.02), <i>p</i> = 0.135) after adjustment for baseline, nutrition risk status, age, and gender. Survival was similar between groups over 12 months. The asynchronous mobile app group had a greater number of withdrawals compared with the telephone group. Conclusion: Early and intensive nutrition counselling, delivered at home, during anticancer treatment did not change quality-adjusted life years or survival over 12 months compared with usual care. Behavioural counselling alone was unable to achieve nutritional adequacy. Dietetic services delivered asynchronously using a mobile app had low acceptance for patients undergoing anticancer treatment. Trial Registration: 27 January 2017 Australian and New Zealand Clinical Trial Registry, ACTRN12617000152325. |
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issn | 2072-6643 |
language | English |
last_indexed | 2024-03-09T05:05:40Z |
publishDate | 2022-08-01 |
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series | Nutrients |
spelling | doaj.art-0fe523ad3aac43cca84a3cb7a682dcd92023-12-03T12:54:26ZengMDPI AGNutrients2072-66432022-08-011415323410.3390/nu14153234Effect of Early and Intensive Telephone or Electronic Nutrition Counselling Delivered to People with Upper Gastrointestinal Cancer on Quality of Life: A Three-Arm Randomised Controlled TrialCatherine E. Huggins0Lauren Hanna1Kate Furness2Mary Anne Silvers3June Savva4Helena Frawley5Daniel Croagh6Paul Cashin7Liang Low8Judy Bauer9Helen Truby10Terry P. Haines11Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168, AustraliaDepartment of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168, AustraliaDepartment of Nutrition and Dietetics, Monash Health, 246 Clayton Road, Clayton, VIC 3168, AustraliaDepartment of Nutrition and Dietetics, Monash Health, 246 Clayton Road, Clayton, VIC 3168, AustraliaDepartment of Nutrition and Dietetics, Monash Health, 246 Clayton Road, Clayton, VIC 3168, AustraliaDepartment of Physiotherapy, Monash University, Level 3 Building G, McMahons Road, Frankston, VIC 3199, AustraliaUpper Gastrointestinal and Hepatobiliary Surgery Unit, Monash Health, 246 Clayton Road, Clayton, VIC 3168, AustraliaUpper Gastrointestinal and Hepatobiliary Surgery Unit, Monash Health, 246 Clayton Road, Clayton, VIC 3168, AustraliaUpper Gastrointestinal and Hepatobiliary Surgery Unit, Monash Health, 246 Clayton Road, Clayton, VIC 3168, AustraliaSchool of Human Movement and Nutrition Sciences, The University of Queensland, Level 2 Connell Building, St. Lucia, QLD 4072, AustraliaDepartment of Physiotherapy, Monash University, Level 3 Building G, McMahons Road, Frankston, VIC 3199, AustraliaDepartment of Physiotherapy, Monash University, Level 3 Building G, McMahons Road, Frankston, VIC 3199, AustraliaBackground: Delay in dietetic service provision for upper gastrointestinal cancer exacerbates disease-related malnutrition and consequently increases morbidity and mortality. Dietetic services are usually referral-based and provided face-to-face in inpatient or outpatient settings, which can delay the commencement of nutrition care. The aim of this study was to provide intensive dietetic intervention close to the time of diagnosis for upper gastrointestinal cancer and assess the effect on quality-adjusted life years. Methods: A three-arm randomised controlled trial of adults newly diagnosed with upper gastrointestinal cancer was performed. A behavioural-based, individually tailored, symptom-directed nutrition intervention was provided in addition to usual care, delivered by a dietitian using a telephone (synchronously) or a mobile application (asynchronously) for 18 weeks, compared with a usual care control group. Data were collected at baseline, three, six, and twelve months post-randomisation. The primary outcome was quality-adjusted life years (EQ-5D-5L quality of life assessment tool). Data were analysed using linear mixed models. Results: One hundred and eleven participants were randomised. Quality-adjusted life years were not different in the intervention groups compared with control (telephone: mean (95% CI) 0.04 (0.43, 2.3), <i>p</i> = 0.998; App: −0.08 (−0.18, 0.02), <i>p</i> = 0.135) after adjustment for baseline, nutrition risk status, age, and gender. Survival was similar between groups over 12 months. The asynchronous mobile app group had a greater number of withdrawals compared with the telephone group. Conclusion: Early and intensive nutrition counselling, delivered at home, during anticancer treatment did not change quality-adjusted life years or survival over 12 months compared with usual care. Behavioural counselling alone was unable to achieve nutritional adequacy. Dietetic services delivered asynchronously using a mobile app had low acceptance for patients undergoing anticancer treatment. Trial Registration: 27 January 2017 Australian and New Zealand Clinical Trial Registry, ACTRN12617000152325.https://www.mdpi.com/2072-6643/14/15/3234mHealthmalnutritionupper gastrointestinal cancerdietetic interventionquality-adjusted life yearsbehaviour change |
spellingShingle | Catherine E. Huggins Lauren Hanna Kate Furness Mary Anne Silvers June Savva Helena Frawley Daniel Croagh Paul Cashin Liang Low Judy Bauer Helen Truby Terry P. Haines Effect of Early and Intensive Telephone or Electronic Nutrition Counselling Delivered to People with Upper Gastrointestinal Cancer on Quality of Life: A Three-Arm Randomised Controlled Trial Nutrients mHealth malnutrition upper gastrointestinal cancer dietetic intervention quality-adjusted life years behaviour change |
title | Effect of Early and Intensive Telephone or Electronic Nutrition Counselling Delivered to People with Upper Gastrointestinal Cancer on Quality of Life: A Three-Arm Randomised Controlled Trial |
title_full | Effect of Early and Intensive Telephone or Electronic Nutrition Counselling Delivered to People with Upper Gastrointestinal Cancer on Quality of Life: A Three-Arm Randomised Controlled Trial |
title_fullStr | Effect of Early and Intensive Telephone or Electronic Nutrition Counselling Delivered to People with Upper Gastrointestinal Cancer on Quality of Life: A Three-Arm Randomised Controlled Trial |
title_full_unstemmed | Effect of Early and Intensive Telephone or Electronic Nutrition Counselling Delivered to People with Upper Gastrointestinal Cancer on Quality of Life: A Three-Arm Randomised Controlled Trial |
title_short | Effect of Early and Intensive Telephone or Electronic Nutrition Counselling Delivered to People with Upper Gastrointestinal Cancer on Quality of Life: A Three-Arm Randomised Controlled Trial |
title_sort | effect of early and intensive telephone or electronic nutrition counselling delivered to people with upper gastrointestinal cancer on quality of life a three arm randomised controlled trial |
topic | mHealth malnutrition upper gastrointestinal cancer dietetic intervention quality-adjusted life years behaviour change |
url | https://www.mdpi.com/2072-6643/14/15/3234 |
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