Practical cancer nutrition, from guidelines to clinical practice: a digital solution to patient-centred care

IF 7.1 2区医学 Q1 ONCOLOGY

ESMO Open Pub Date : 2025-04-01 DOI:10.1016/j.esmoop.2025.104529

K.S. Hustad , L.H. Koteng , A. Urrizola , J. Arends , A. Bye , O. Dajani , L. Deliens , M. Fallon , M.J. Hjermstad , M. Kohlen , G.P. Kurita , T. Lundeby , N. Mitrea , C. Payne , S. Roselló-Keränen , N. Warmbrodt , A. de Wilde , S. Kaasa , J. de Vos-Geelen , B.J.A. Laird , R. Williams

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引用次数: 0

Abstract

Background

Malnutrition affects 20%-70% of cancer patients, depending on tumour type, disease stage, and clinical setting. While nutritional care is essential for improving patients’ quality of life and clinical outcomes, it is not systematically integrated into routine cancer care. MyPath is a European Union project aiming to implement patient-centred care (PCC) at nine European cancer centres using implementation science. Multidisciplinary teams have developed standardised digitally supported PCC pathways based on patient-reported outcomes (PROs) with linked evidence-based management options. Through systematic assessment and management of common symptoms and psychosocial problems in cancer patients, MyPath aims to facilitate changes in clinical practice to improve PCC for all. As part of this, the MyPath Nutrition Care Pathway (NCP) aims to facilitate necessary clinical changes to routinely assess and address nutrition in all patients.

Materials and methods

Between September 2022 and August 2024, an international multidisciplinary team reviewed evidence-based nutrition guidelines to select relevant PROs and other variables necessary to systematically assess patients, allowing for tailored nutritional care.

Results

The MyPath NCP assessment relies on nutritional status (Malnutrition Screening Tool for malnutrition risk, modified Global Leadership Initiative on Malnutrition criteria for malnutrition, and body mass index/weight change for obesity/unintentional weight gain), health status (functional status, cancer diagnosis and prognosis, and prehabilitation needs), and inflammatory status (C-reactive protein levels). Based on this assessment, the digital solution suggests tailored, evidence-based nutritional interventions. Continuous monitoring through PROs and clinical consultations will customise care to patients’ dynamic nutritional needs. The first version of this digital solution will be piloted in 2025.

Conclusions

Inconsistent implementation of nutrition guidelines is a key challenge in cancer care. The MyPath NCP offers an accessible, patient-centred assessment and management system that integrates nutritional care into routine cancer care, providing a versatile solution that can be implemented across diverse health care settings.

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实用癌症营养，从指南到临床实践：以患者为中心的护理的数字化解决方案

营养不良影响20%-70%的癌症患者，这取决于肿瘤类型、疾病分期和临床环境。虽然营养护理对改善患者的生活质量和临床结果至关重要，但它并没有系统地纳入常规癌症护理。MyPath是一个欧盟项目，旨在利用实施科学在9个欧洲癌症中心实施以患者为中心的护理（PCC）。多学科团队基于患者报告的结果（PROs）开发了标准化的数字支持PCC途径，并提供了相关的循证管理方案。通过系统评估和管理癌症患者的常见症状和心理社会问题，MyPath旨在促进临床实践的变化，以改善所有癌症患者的PCC。作为其中的一部分，MyPath营养护理路径（NCP）旨在促进必要的临床改变，以常规评估和解决所有患者的营养问题。材料和方法在2022年9月至2024年8月期间，一个国际多学科团队审查了以证据为基础的营养指南，以选择系统评估患者所需的相关PROs和其他变量，从而实现量身定制的营养护理。结果MyPath NCP评估依赖于营养状况（营养不良风险的营养不良筛查工具、营养不良的修正全球领导倡议标准、肥胖/非故意体重增加的体重指数/体重变化）、健康状况（功能状态、癌症诊断和预后、康复需求）和炎症状态（c反应蛋白水平）。基于这一评估，数字解决方案提出了有针对性的、以证据为基础的营养干预措施。通过专业医生和临床咨询进行持续监测，将根据患者的动态营养需求定制护理。该数字解决方案的第一个版本将于2025年进行试点。结论营养指南的一致性实施是癌症治疗的关键挑战。MyPath NCP提供了一个可访问的、以患者为中心的评估和管理系统，将营养护理纳入常规癌症护理，提供了一个可在不同卫生保健环境中实施的通用解决方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ESMO Open Medicine-Oncology

CiteScore

11.70

自引率

2.70%

发文量

255

审稿时长

10 weeks

期刊介绍： ESMO Open is the online-only, open access journal of the European Society for Medical Oncology (ESMO). It is a peer-reviewed publication dedicated to sharing high-quality medical research and educational materials from various fields of oncology. The journal specifically focuses on showcasing innovative clinical and translational cancer research. ESMO Open aims to publish a wide range of research articles covering all aspects of oncology, including experimental studies, translational research, diagnostic advancements, and therapeutic approaches. The content of the journal includes original research articles, insightful reviews, thought-provoking editorials, and correspondence. Moreover, the journal warmly welcomes the submission of phase I trials and meta-analyses. It also showcases reviews from significant ESMO conferences and meetings, as well as publishes important position statements on behalf of ESMO. Overall, ESMO Open offers a platform for scientists, clinicians, and researchers in the field of oncology to share their valuable insights and contribute to advancing the understanding and treatment of cancer. The journal serves as a source of up-to-date information and fosters collaboration within the oncology community.