Poor nutrition status associated with low patient satisfaction six months into treatment for head and neck/esophageal cancer treatment: A prospective multicenter cohort study

Adrianne M Widaman; Andrew G Day; Maggie A Kuhn; Rupinder Dhaliwal; Vickie Baracos; Merran Findlay; Judith D Bauer; Marian de van der Schueren; Alessandro Laviano; Lisa Martin; Leah Gramlich

doi:10.1002/ncp.11211

Poor nutrition status associated with low patient satisfaction six months into treatment for head and neck/esophageal cancer treatment: A prospective multicenter cohort study

Nutr Clin Pract. 2024 Sep 22. doi: 10.1002/ncp.11211. Online ahead of print.

Authors

Adrianne M Widaman^{1

2}, Andrew G Day³, Maggie A Kuhn², Rupinder Dhaliwal⁴, Vickie Baracos⁵, Merran Findlay^{6

7

8

9}, Judith D Bauer¹⁰, Marian de van der Schueren^{11

12}, Alessandro Laviano¹³, Lisa Martin¹⁴, Leah Gramlich¹⁴

Affiliations

¹ Department of Nutrition Food Science and Packaging, San Jose State University, San Jose, California, USA.
² Department of Otolaryngology, University of California Davis Medical Center, Sacramento, California, USA.
³ Department of Public Health Sciences, Queens' University, Kingston, Ontario, Canada.
⁴ Canadian Nutrition Society, Ottawa, Ontario, Canada.
⁵ Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada.
⁶ Cancer Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
⁷ Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.
⁸ Cancer Care Research Unit, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.
⁹ Cancer Clinical Academic Group, South Western Sydney Clinical School, Maridulu Budyari Gumal (SPHERE), University of New South Wales, Sydney, New South Wales, Australia.
¹⁰ Department of Nutrition Dietetics and Food, Monash University, Clayton, Victoria, Australia.
¹¹ Department of Nutrition Dietetics and Lifestyle School of Allied Health, HAN University of Applied Sciences, Nijmegen, Gelderland, the Netherlands.
¹² Department of Human Nutrition and Health, Wageningen University and Research, Wageningen, Gelderland, the Netherlands.
¹³ Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
¹⁴ Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

PMID: 39306726
DOI: 10.1002/ncp.11211

Abstract

Background: Patient-reported outcome measures have been associated with survival in oncology patients. Altered intake and malnutrition are common symptoms for patients treated for head and neck cancer and esophageal cancer (HNC/EC). The purpose of this study was to examine the relationship between patient-reported satisfaction with medical care and nutrition status.

Methods: This prospective cohort study collected data from 11 international cancer care sites.

Results: One hundred and sixtythree adult patients (n = 115 HNC; n = 48 EC) completed a patient satisfaction questionnaire (the Canadian Health Care Evaluation Project Lite) and were included. HNC/EC patient global satisfaction with medical care was 88.3/100 ± 15.3 at baseline and remained high at 86.6/100 ± 16.8 by 6 months (100 max satisfaction score). Poor nutrition status, as defined by the Patient-Generated Subjective Global Assessment Short Form, was associated with lower patient satisfaction with overall medical care, relationship with doctors, illness management, communication, and decision-making 6 months into treatment (P < 0.01). There was no difference in global satisfaction between patients who did and did not report swallowing difficulty (P = 0.99) and patients with and without feeding tube placement (P = 0.36). Patients who were seen by a dietitian for at least one nutrition assessment had global satisfaction with care that was 16.7 percentage points higher than those with no nutrition assessment (89.3 ± 13.8 vs 72.6 ± 23.6; P = 0.005) CONCLUSION: In HNC/EC patient-centered oncology care, decreasing malnutrition risk and providing access to dietitian-led nutrition assessments should be prioritized and supported to improve patient satisfaction and standard of care. Feeding tube placement did not decrease patient satisfaction with medical care.

Keywords: adult; enteral nutrition; life cycle; nutrition; nutrition assessment; nutrition support practice; nutrition support teams; oncology; outcomes research/quality; public policy; research and diseases.

Grants and funding

Funding was provided by Fresenius Kabi.