Translating Evidence-Based Guidelines into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM)
Malnutrition is highly prevalent in patients with foregut tumors comprising head and neck (HNC) and esophageal (EC) cancers, negatively impacting outcomes. International evidence-based guidelines (EBGs) for nutrition care exist; however, translation of research evidence into practice commonly presen...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-12-01
|
| Series: | Nutrients |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6643/12/12/3808 |
| _version_ | 1797544959809683456 |
|---|---|
| author | Merran Findlay Judith D. Bauer Rupinder Dhaliwal Marian de van der Schueren Alessandro Laviano Adrianne Widaman Lisa Martin Andrew G. Day Leah M. Gramlich |
| author_facet | Merran Findlay Judith D. Bauer Rupinder Dhaliwal Marian de van der Schueren Alessandro Laviano Adrianne Widaman Lisa Martin Andrew G. Day Leah M. Gramlich |
| author_sort | Merran Findlay |
| collection | DOAJ |
| description | Malnutrition is highly prevalent in patients with foregut tumors comprising head and neck (HNC) and esophageal (EC) cancers, negatively impacting outcomes. International evidence-based guidelines (EBGs) for nutrition care exist; however, translation of research evidence into practice commonly presents considerable challenges and consequently lags. This study aimed to describe and evaluate current international nutrition care practices compared with the best-available evidence for patients with foregut tumors who are at high risk of malnutrition. A multi-centre prospective cohort study enrolled 170 patients commencing treatment of curative intent for HNC (<i>n</i> = 119) or EC (<i>n</i> = 51) in 11 cancer care settings in North America, Europe and Australia between 2016 and 2018. Adherence criteria were derived from relevant EBG recommendations with pooled results for participating centres reported according to the Nutrition Care Model at either system or patient levels. Adherence to EBG recommendations was: good (≥80%) for performing baseline nutrition screening and assessment, perioperative nutrition assessment and nutrition prescription for energy and protein targets; moderate (≥60 to 80%) for utilizing validated screening and assessment tools and pre-radiotherapy dietitian consultation; and poor (60%) for initiating post-operative nutrition support within 24 h and also dietetic consultation weekly during radiotherapy and fortnightly for 6 weeks post-radiotherapy. In conclusion, gaps in evidence-based cancer nutrition care remain; however, this may be improved by filling known evidence gaps through high-quality research with a concurrent evolution of EBGs to also encompass practical implementation guidance. These should aim to support multidisciplinary cancer clinicians to close evidence–practice gaps throughout the patient care trajectory with clearly defined roles and responsibilities that also address patient-reported concerns. |
| first_indexed | 2024-03-10T14:07:51Z |
| format | Article |
| id | doaj.art-7f857a167e9c4f50be305dfed0aa8f03 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T14:07:51Z |
| publishDate | 2020-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-7f857a167e9c4f50be305dfed0aa8f032023-11-21T00:28:49ZengMDPI AGNutrients2072-66432020-12-011212380810.3390/nu12123808Translating Evidence-Based Guidelines into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM)Merran Findlay0Judith D. Bauer1Rupinder Dhaliwal2Marian de van der Schueren3Alessandro Laviano4Adrianne Widaman5Lisa Martin6Andrew G. Day7Leah M. Gramlich8Cancer Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, AustraliaSchool of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD 4072, AustraliaCanadian Nutrition Society, Ottawa, ON K1C 6A8, CanadaDepartment of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, 6503 GL Nijmegen, The NetherlandsDepartment of Translational and Precision Medicine, Sapienza University of Rome, I-00185 Rome, ItalyDepartment of Nutrition, Food Science and Packaging, San Jose State University, San Jose, CA 95192, USADepartment of Medicine, Cross Cancer Institute, University of Alberta, Edmonton, AB T6G 1Z2, CanadaDepartment of Public Health Sciences, Queen’s University, Kingston, ON K7L 2V7, CanadaRoyal Alexandra Hospital, Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB T5H 3V9, CanadaMalnutrition is highly prevalent in patients with foregut tumors comprising head and neck (HNC) and esophageal (EC) cancers, negatively impacting outcomes. International evidence-based guidelines (EBGs) for nutrition care exist; however, translation of research evidence into practice commonly presents considerable challenges and consequently lags. This study aimed to describe and evaluate current international nutrition care practices compared with the best-available evidence for patients with foregut tumors who are at high risk of malnutrition. A multi-centre prospective cohort study enrolled 170 patients commencing treatment of curative intent for HNC (<i>n</i> = 119) or EC (<i>n</i> = 51) in 11 cancer care settings in North America, Europe and Australia between 2016 and 2018. Adherence criteria were derived from relevant EBG recommendations with pooled results for participating centres reported according to the Nutrition Care Model at either system or patient levels. Adherence to EBG recommendations was: good (≥80%) for performing baseline nutrition screening and assessment, perioperative nutrition assessment and nutrition prescription for energy and protein targets; moderate (≥60 to 80%) for utilizing validated screening and assessment tools and pre-radiotherapy dietitian consultation; and poor (60%) for initiating post-operative nutrition support within 24 h and also dietetic consultation weekly during radiotherapy and fortnightly for 6 weeks post-radiotherapy. In conclusion, gaps in evidence-based cancer nutrition care remain; however, this may be improved by filling known evidence gaps through high-quality research with a concurrent evolution of EBGs to also encompass practical implementation guidance. These should aim to support multidisciplinary cancer clinicians to close evidence–practice gaps throughout the patient care trajectory with clearly defined roles and responsibilities that also address patient-reported concerns.https://www.mdpi.com/2072-6643/12/12/3808head and neck canceresophageal cancermalnutritionimplementationevidence-based practiceresearch translation |
| spellingShingle | Merran Findlay Judith D. Bauer Rupinder Dhaliwal Marian de van der Schueren Alessandro Laviano Adrianne Widaman Lisa Martin Andrew G. Day Leah M. Gramlich Translating Evidence-Based Guidelines into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM) Nutrients head and neck cancer esophageal cancer malnutrition implementation evidence-based practice research translation |
| title | Translating Evidence-Based Guidelines into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM) |
| title_full | Translating Evidence-Based Guidelines into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM) |
| title_fullStr | Translating Evidence-Based Guidelines into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM) |
| title_full_unstemmed | Translating Evidence-Based Guidelines into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM) |
| title_short | Translating Evidence-Based Guidelines into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM) |
| title_sort | translating evidence based guidelines into practice are we getting it right a multi centre prospective international audit of nutrition care in patients with foregut tumors inform |
| topic | head and neck cancer esophageal cancer malnutrition implementation evidence-based practice research translation |
| url | https://www.mdpi.com/2072-6643/12/12/3808 |
| work_keys_str_mv | AT merranfindlay translatingevidencebasedguidelinesintopracticearewegettingitrightamulticentreprospectiveinternationalauditofnutritioncareinpatientswithforeguttumorsinform AT judithdbauer translatingevidencebasedguidelinesintopracticearewegettingitrightamulticentreprospectiveinternationalauditofnutritioncareinpatientswithforeguttumorsinform AT rupinderdhaliwal translatingevidencebasedguidelinesintopracticearewegettingitrightamulticentreprospectiveinternationalauditofnutritioncareinpatientswithforeguttumorsinform AT mariandevanderschueren translatingevidencebasedguidelinesintopracticearewegettingitrightamulticentreprospectiveinternationalauditofnutritioncareinpatientswithforeguttumorsinform AT alessandrolaviano translatingevidencebasedguidelinesintopracticearewegettingitrightamulticentreprospectiveinternationalauditofnutritioncareinpatientswithforeguttumorsinform AT adriannewidaman translatingevidencebasedguidelinesintopracticearewegettingitrightamulticentreprospectiveinternationalauditofnutritioncareinpatientswithforeguttumorsinform AT lisamartin translatingevidencebasedguidelinesintopracticearewegettingitrightamulticentreprospectiveinternationalauditofnutritioncareinpatientswithforeguttumorsinform AT andrewgday translatingevidencebasedguidelinesintopracticearewegettingitrightamulticentreprospectiveinternationalauditofnutritioncareinpatientswithforeguttumorsinform AT leahmgramlich translatingevidencebasedguidelinesintopracticearewegettingitrightamulticentreprospectiveinternationalauditofnutritioncareinpatientswithforeguttumorsinform |