Palliative Care Team Involvement Is Associated with Changes in Nutrition Impact Symptoms and Eating-Related Distress in Patients with Advanced Cancer: A Multicenter Prospective Observational Study.
Evidence on the effects of palliative care team interventions on cachexia remains limited. We examined the effects on nutrition impact symptoms (NISs), dietary intake, and eating-related distress (ERD) among advanced cancer patients.
This was a multicenter prospective observational study. Participants completed the baseline survey and the follow-up survey one week later. They evaluated NISs, dietary intake, and ERD. We compared the patient-reported outcomes between the two surveys. We categorized the participants having four or more NISs with a score ≥ 4 into the High-NIS group (otherwise, the Low-NIS group) using their baseline scores. Changes in the number of symptoms with a score ≥ 4, the dietary intake, and the ERD scores were calculated. Multiple regression analyses were performed to identify the factors influencing the improvements in dietary intake and ERD.
A total of 123 patients were included. In all patients, pain, fatigue, lack of appetite, sadness, and ERD significantly improved (p = 0.001, 0.023, 0.043, 0.037, <0.001). In the High-NIS group, the number of symptoms with a score ≥ 4 significantly decreased (p = 0.009), dietary intake scores significantly increased (p = 0.037), and ERD scores significantly decreased (p = 0.001). The number of symptoms with a score ≥ 4 at baseline (B = 1.08, p = 0.044, 95% confidence interval 0.03 to 2.14) was the only independent factor influencing the improvements in dietary intake.
NISs and ERD improvements were associated with the interventions. Dietary intake improvement was associated with a high baseline symptom burden.
This was a multicenter prospective observational study. Participants completed the baseline survey and the follow-up survey one week later. They evaluated NISs, dietary intake, and ERD. We compared the patient-reported outcomes between the two surveys. We categorized the participants having four or more NISs with a score ≥ 4 into the High-NIS group (otherwise, the Low-NIS group) using their baseline scores. Changes in the number of symptoms with a score ≥ 4, the dietary intake, and the ERD scores were calculated. Multiple regression analyses were performed to identify the factors influencing the improvements in dietary intake and ERD.
A total of 123 patients were included. In all patients, pain, fatigue, lack of appetite, sadness, and ERD significantly improved (p = 0.001, 0.023, 0.043, 0.037, <0.001). In the High-NIS group, the number of symptoms with a score ≥ 4 significantly decreased (p = 0.009), dietary intake scores significantly increased (p = 0.037), and ERD scores significantly decreased (p = 0.001). The number of symptoms with a score ≥ 4 at baseline (B = 1.08, p = 0.044, 95% confidence interval 0.03 to 2.14) was the only independent factor influencing the improvements in dietary intake.
NISs and ERD improvements were associated with the interventions. Dietary intake improvement was associated with a high baseline symptom burden.
Authors
Amano Amano, Koshimoto Koshimoto, Sakaguchi Sakaguchi, Tokoro Tokoro, Arakawa Arakawa, Takeuchi Takeuchi, Mori Mori, Matsuda Matsuda, Satomi Satomi, Harano Harano, Miyashita Miyashita
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