Aims:
Home enteral nutrition (HEN) is the provision of nutrition support in the home setting. In Victoria, HEN programs cover formula and consumable costs for patients and eligibility has traditionally been limited to patients receiving nutrition support via a feeding tube. However, in 2020 the Victorian HEN funding guidelines were modified, enabling patients receiving >70% of their nutritional requirements via oral nutrition support to access the program. This study aimed to describe the clinical characteristics of cancer patients accessing the HEN program of a specialist cancer hospital.
Methods:
A retrospective audit of demographic and clinical data of HEN eligible patients, extracted from a prospective database, was conducted for the 2020-2021 financial year. Data was analysed using descriptive statistics.
Results:
Of the 426 patients on the HEN program in 2020-2021, 76% (n=324) were male and the mean age was 63 years (range: 21-90 years). Seventy one percent (n=303) received enteral nutrition only, 29% (n=123) oral nutrition support only and 12% (n=52) had sequential episodes of oral and enteral nutrition support. Expansion of HEN funding eligibility to include oral nutrition support saw the HEN program expand by 52% (n=146) in 2020-2021, compared to 2019-2020. The majority of patients had either head and neck or upper gastrointestinal cancer (82% and 13% respectively). Of patients receiving enteral nutrition, 45% (n=140) were fed via a percutaneous endoscopic gastrostomy (PEG) and 37% (n=114) via nasogastric tube (NGT). The average time fed via PEG was 181 days compared to 58 days for NGT.
Conclusion:
Expansion of Victorian HEN funding eligibility to include patients largely reliant on oral nutrition support resulted in substantial HEN program growth. Head and neck cancer patients comprise the majority of HEN program users. This study provides insights into the workforce and clinical service design required to best support a large cancer-specific HEN program.