e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

The effects of a family-centered psychosocial-based nutrition intervention in patients with advanced cancer: the PiCNIC2 pilot randomised controlled trial (#213)

Alex Molassiotis 1 , Teresa Brown 2 3 , Hui Lin Cheng 1 , Angela Byrnes 3 , Raymond Chan 4 5 , David Wyld 3 4 6 , Melissa Eastgate 3 6 , Patsy Yates 4 , Andrea Marshall 7 8 , Rebecca Fichera 3 , Elisabeth Isenring 9 , Ki Fung To 1 , Po Shan Ko 10 , Wang Lam 11 , Yuk Fong Lam 11 , Lai Fan Au 12 , See-kit Raymond Lo 12
  1. School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong
  2. Centre for Dietetics Research (C-DIET-R), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
  3. Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia
  4. School of Nursing and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Queensland, Australia
  5. Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  6. School of Medicine, University of Queensland, Brisbane, Queensland, Australia
  7. Gold Coast University Hospital, Southport, Queensland, Australia
  8. Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
  9. Nutrition & Dietetics, Bond University, Gold Coast, Queensland, Australia
  10. Kowloon East Cluster, Hospital Authority, Kowloon, Hong Kong
  11. Haven of Hope Hospital, Tseung Kwan O, Hong Kong
  12. Shatin Hospital, New Territories, Hong Kong

Aims: To explore feasibility and preliminary outcomes of a randomised controlled trial, using a family-centred, psychosocial-based, nutrition intervention in patients with advanced cancer identified at risk of malnutrition.

Methods: Pilot randomised controlled multicentre trial in Australia and Hong Kong. Patients with or without family caregivers were randomised to receive usual care or intensive nutrition counselling consisting of three dietitian appointments over a 4-6-week period. The aim of the intervention was to address nutrition impact symptoms, food or eating-related psychosocial concerns and set appropriate nutritional goals in conjunction with the patient and carer. Feasibility assessment included recruitment, consent rate, retention rate, and assessment tool acceptability. Validated nutritional and quality of life self-reported measures were used to collect outcomes at baseline and on conclusion of the intervention.

Results: Seventy-four patients and 54 family caregivers participated in the study, with 34 patients randomised to the intervention and 40 to usual care. Recruitment rates were between 7-15%, with consent rates of 44% in patients and 55% in caregivers. Retention rates were 82% (Australia) and 62% (Hong Kong), however approximately only half of all participants returned the outcome assessment forms. Acceptability of the assessment tools (on a 10-point scale) ranged from 6.28-7.99 for patients and 5.18-8.55 in carers.

Patient outcome data were promising for those receiving the intervention, particularly showing improvements in eating-related distress (p=0.046 in the Australian data; p=0.07 in the Hong Kong data), eating-related enjoyment (p=0.024, Hong Kong data) and quality of life (p=0.045, Australian data). Energy and protein intake also increased in a clinically meaningful way. However, caregiver data showed little change.

Conclusions: Despite difficulties with recruitment, the intervention demonstrates good potential to have positive effects on patients’ eating-related distress and quality of life. The results of this trial warrant a larger and fully-powered trial to ascertain the effectiveness of this intervention.