e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

Awareness and perceptions of nutrition support in upper gastrointestinal cancer surgery: A national survey of multidisciplinary clinicians (#267)

Irene Deftereos 1 2 , Nicole Kiss 3 , Teresa Brown 4 , Sharon Carey 5 , Vanessa Carter 2 , Val Usatoff 1 , Sumitra Ananda 6 , Justin Yeung 1
  1. Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
  2. Nutrition and Dietetics, Western Health, Melbourne, Victoria, Australia
  3. Institute for physical activity and nutrition, Deakin University, Melbourne, Victoria, Australia
  4. Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
  5. Nutrition and Dietetics, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
  6. Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia

Background: A multidisciplinary approach to nutritional management of patients undergoing surgery for upper gastrointestinal (UGI) cancer is recommended. This study aimed to determine practices, awareness and perceptions of multi-disciplinary clinicians with regards to malnutrition screening and provision of nutrition support.

Methods: A national Australian survey of dietitians, surgeons, oncologists and nurses was conducted using a 30-item online REDCap survey, including questions regarding self-reported malnutrition screening/nutrition support practices, awareness and perceptions, and barriers and enablers. The survey was distributed via professional organisations/networks between 1st September and 30th November 2020. Results are presented as counts and percentages.

Results: There were 130 participants (56% dietitians, 25% surgeons, 11% nurses, 8% oncologists). The majority reported that dietitians and nurses performed malnutrition screening, and dietitians and surgeons prescribed nutrition support. Most participants reported that their health service had dietetics support available (98%), however only 43% reported having an outpatient service. Participants (>90%) demonstrated very high awareness of the significance of malnutrition and the importance of early nutrition support. Participants mostly perceived dietitians, nurses and surgeons to be responsible for malnutrition screening, whilst responsibility of prescription of nutrition support was mostly dietitians and surgeons. There were a higher number of barriers for the outpatient setting (48%) than the inpatient setting (38%). Top ranked barriers were variation in practices between surgeons for insertion of feeding tubes or escalation of nutrition support, lack of standard procedures or clinical pathways and lack of funding and availability of dietitians.  

Conclusions: Participants identified a high awareness of the importance of identification and treatment of malnutrition in UGI cancer surgery. However reported practices varied and appear to be lacking in the outpatient setting, with significant barriers identified to providing optimal nutrition care.