Assessing Impact of Nutrition Care by Registered Dietitian Nutritionists on Patient Medical and Treatment Outcomes in Outpatient Cancer Clinics: A Cohort Feasibility Study

Authors

Dolores D. Guest, Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA; University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
Tricia Cox, Department of Nutrition, Baylor University Medical Center, Dallas, TX, USA
Anne Coble Voss, Human Nutrition, University of Alberta, Alberta, Canada
Kathryn Kelley, Research, International and Scientific Affairs, Nutrition Research Network, Academy of Nutrition and Dietetics, Chicago, IL, USA
Xingya Ma, Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA; College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
Andreea Nguyen, Department of Nutrition, Baylor University Medical Center, Dallas, TX, USA
Kerry McMillen, Fred Hutchinson Cancer Center, Seattle, WA, USA
Valaree Williams, American Oncology Network, FL, USA
James A. Lee, Research, International and Scientific Affairs, Nutrition Research Network, Academy of Nutrition and Dietetics, Chicago, IL, USA
Jennifer Petersen, Telligen, IA, USA
Karilynne Lenning, Telligen, IA, USA
Elizabeth Yakes Jimenez, Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA; Research, International and Scientific Affairs, Nutrition Research Network, Academy of Nutrition and Dietetics, Chicago, IL, USA; Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA

Document Type

Article

Publication Date

1-1-2023

Abstract

More information is needed about the impact of outpatient nutrition care from a registered dietitian nutritionist (RDN) on patient outcomes. This study aimed to assess the feasibility of a cohort study design to evaluate impact of RDN nutrition care on patient outcomes, describe clinic malnutrition screening practices, and estimate statistical parameters for a larger study. Seventy-seven patients with lung, esophageal, colon, rectal, or pancreatic cancer from six facilities were included (41 received RDN care and 36 did not). RDN nutrition care was prospectively documented for six months and documented emergency room visits, unplanned hospitalizations and treatment changes were retrospectively abstracted from medical records. Most facilities used the Malnutrition Screening Tool (MST) to determine malnutrition risk. Patients receiving RDN care had, on average, five, half hour visits and had more severe disease and higher initial malnutrition risk, although this varied across sites. Documented medical and treatment outcomes were relatively rare and similar between groups. Estimated sample size requirements varied from 113 to 5856, depending on tumor type and outcome, and intracluster correlation coefficients (ICCs) ranged from 0 to 0.47. Overall, the methods used in this study are feasible but an interventional or implementation design might be advantageous for a larger study.

Publisher

Lawrence Erlbaum Associates

Publication Title

Nutrition and cancer

ISSN

1532-7914

Volume

75

Issue

3

First Page

923

Last Page

936

DOI

10.1080/01635581.2023.2170431

Recommended Citation

Guest DD, Cox T, Voss AC, Kelley K, Ma X, Nguyen A, McMillen K, Williams V, Lee JA, Petersen J, Lenning K, Yakes Jimenez E. Assessing Impact of Nutrition Care by Registered Dietitian Nutritionists on Patient Medical and Treatment Outcomes in Outpatient Cancer Clinics: A Cohort Feasibility Study. Nutr Cancer. 2023;75(3):923-936. doi: 10.1080/01635581.2023.2170431. Epub 2023 Jan 24. PMID: 36691979; PMCID: PMC10029747.