Emilie Croisier1,2, Kelly D'cunha3, Teresa Brown3,4, Judy Bauer3. 1. School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building, St Lucia, Brisbane, QLD, 4072, Australia. emilie.croisier@uqconnect.edu.au. 2. Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, 4029, QLD, Australia. emilie.croisier@uqconnect.edu.au. 3. School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building, St Lucia, Brisbane, QLD, 4072, Australia. 4. Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, 4029, QLD, Australia.
Abstract
PURPOSE: Radiotherapy for gynaecological cancers often causes gastrointestinal (GI) toxicities such as diarrhoea. Evidence for the potential benefits of dietary interventions on the management of acute GI toxicities is inconclusive and of low quality, with no clear evidence-based guidelines to inform clinical practice. This study aims to provide an overview of current opinions and clinical practice of dietitians treating this cohort and to examine existing models of nutrition care in Australian cancer centres. METHODS: Semi-structured interviews were conducted over a video conferencing service to collect information relating to: demographic characteristics; referral protocol and post-treatment pathways; management strategies and interventions prescribed; and attitudes and confidence in service provided. Descriptive analysis was performed on quantitative data, and thematic analysis was performed on qualitative data. RESULTS: In total, 17 dietitians across Australia participated in the study. Almost all centres (94%) had dietetics services available for this patient cohort; however, most did not have an automatic referral pathway (94%) or post-treatment pathway (88%). The opinions and prescription of dietary interventions for symptom management had multiple variations of a 'low' or 'modified-fibre' diet with differing ratios of soluble and insoluble fibre. Over half of the respondents believed that practice was not standardized within their workplace (58%) or Australia (82%). CONCLUSION: There are variations in service provision with respect to opinions and prescription of dietary modifications within dietetic practice across Australia. The present study highlights the need to investigate the efficacy of dietary interventions on symptom management to better inform evidence-based models of care.
PURPOSE: Radiotherapy for gynaecological cancers often causes gastrointestinal (GI) toxicities such as diarrhoea. Evidence for the potential benefits of dietary interventions on the management of acute GI toxicities is inconclusive and of low quality, with no clear evidence-based guidelines to inform clinical practice. This study aims to provide an overview of current opinions and clinical practice of dietitians treating this cohort and to examine existing models of nutrition care in Australian cancer centres. METHODS: Semi-structured interviews were conducted over a video conferencing service to collect information relating to: demographic characteristics; referral protocol and post-treatment pathways; management strategies and interventions prescribed; and attitudes and confidence in service provided. Descriptive analysis was performed on quantitative data, and thematic analysis was performed on qualitative data. RESULTS: In total, 17 dietitians across Australia participated in the study. Almost all centres (94%) had dietetics services available for this patient cohort; however, most did not have an automatic referral pathway (94%) or post-treatment pathway (88%). The opinions and prescription of dietary interventions for symptom management had multiple variations of a 'low' or 'modified-fibre' diet with differing ratios of soluble and insoluble fibre. Over half of the respondents believed that practice was not standardized within their workplace (58%) or Australia (82%). CONCLUSION: There are variations in service provision with respect to opinions and prescription of dietary modifications within dietetic practice across Australia. The present study highlights the need to investigate the efficacy of dietary interventions on symptom management to better inform evidence-based models of care.
Authors: Linda Wedlake; Clare Shaw; Helen McNair; Amyn Lalji; Kabir Mohammed; Tanya Klopper; Lindsey Allan; Diana Tait; Maria Hawkins; Navita Somaiah; Susan Lalondrelle; Alexandra Taylor; Nicholas VanAs; Alexandra Stewart; Sharadah Essapen; Heather Gage; Kevin Whelan; H Jervoise N Andreyev Journal: Am J Clin Nutr Date: 2017-07-05 Impact factor: 7.045