Sophie E Hogan1, Michael J Solomon2,3, Sharon K Carey2,3. 1. Royal Prince Alfred Hospital, Sydney, NSW, Australia. sophie.hogan@health.nsw.gov.au. 2. Royal Prince Alfred Hospital, Sydney, NSW, Australia. 3. University of Sydney, Sydney, NSW, Australia.
Abstract
PURPOSE: Compliance with oral nutrition support (ONS) is poorly reported in the literature. Many factors influence compliance, which could mask the true benefits of preoperative ONS. Surgical oncology patients, including pelvic exenteration patients, are often requested by healthcare workers to consume nutrition supplements before surgery. Exploration of barriers and enablers to compliance with nutrition supplements is needed to improve patient compliance and understand the real impact of preoperative ONS. METHOD: A qualitative study using semi-structured interviews was performed to investigate enablers and barriers to preoperative nutrition supplement compliance. Twenty participants who had been asked to consume 15 nutrition supplements, either immunonutrition or standard polymeric supplements, were interviewed. Inductive thematic analysis was used to determine major themes associated with compliance. RESULTS:Twelve out of 20 participants were not compliant with recommended dosing. Well-nourished participants were more compliant than malnourished participants. Major themes associated with compliance were flavour, volume, texture, impact on dietary intake and motivation to consume supplements. Flavour differed between the two groups, negatively impacting compliance in the immunonutrition group. Volume, texture and impact on dietary intake also negatively impacted compliance whereas motivation positively impacted compliance. CONCLUSION: To overcome barriers and enforce enablers with nutrition supplement compliance, it is essential healthcare workers implement individualised interventions, taking into account nutritional status. A range of flavours, minimal volume and low viscosity supplements should be provided to address individual preference and minimise poor compliance. Better-targeted education and regular motivation are needed to improve compliance.
RCT Entities:
PURPOSE: Compliance with oral nutrition support (ONS) is poorly reported in the literature. Many factors influence compliance, which could mask the true benefits of preoperative ONS. Surgical oncology patients, including pelvic exenteration patients, are often requested by healthcare workers to consume nutrition supplements before surgery. Exploration of barriers and enablers to compliance with nutrition supplements is needed to improve patient compliance and understand the real impact of preoperative ONS. METHOD: A qualitative study using semi-structured interviews was performed to investigate enablers and barriers to preoperative nutrition supplement compliance. Twenty participants who had been asked to consume 15 nutrition supplements, either immunonutrition or standard polymeric supplements, were interviewed. Inductive thematic analysis was used to determine major themes associated with compliance. RESULTS: Twelve out of 20 participants were not compliant with recommended dosing. Well-nourished participants were more compliant than malnourished participants. Major themes associated with compliance were flavour, volume, texture, impact on dietary intake and motivation to consume supplements. Flavour differed between the two groups, negatively impacting compliance in the immunonutrition group. Volume, texture and impact on dietary intake also negatively impacted compliance whereas motivation positively impacted compliance. CONCLUSION: To overcome barriers and enforce enablers with nutrition supplement compliance, it is essential healthcare workers implement individualised interventions, taking into account nutritional status. A range of flavours, minimal volume and low viscosity supplements should be provided to address individual preference and minimise poor compliance. Better-targeted education and regular motivation are needed to improve compliance.
Authors: Jann Arends; Patrick Bachmann; Vickie Baracos; Nicole Barthelemy; Hartmut Bertz; Federico Bozzetti; Ken Fearon; Elisabeth Hütterer; Elizabeth Isenring; Stein Kaasa; Zeljko Krznaric; Barry Laird; Maria Larsson; Alessandro Laviano; Stefan Mühlebach; Maurizio Muscaritoli; Line Oldervoll; Paula Ravasco; Tora Solheim; Florian Strasser; Marian de van der Schueren; Jean-Charles Preiser Journal: Clin Nutr Date: 2016-08-06 Impact factor: 7.324
Authors: Jacco J de Haan; Remco J Renken; Yvette Moshage; Daniëlle A Kluifhooft; Camille Corbier; Louise E Daly; Hélène Blanchard; Anna K L Reyners Journal: Support Care Cancer Date: 2021-02-25 Impact factor: 3.603