Knowledge, attitudes and practices relating to nutritional support and immune-related adverse events among patients undergoing immunotherapy for liver cancer: cross-sectional study.

Objectives: To examine the knowledge, attitude and practice (KAP) regarding immune-related adverse events (irAEs) and nutritional support among patients with liver cancer (LC).

Design: Cross-sectional study.

Setting: Recruitment was carried out at Haikou People's Hospital, Haikou, China, from December 2022 to April 2023.

Participants: Patients undergoing immunotherapy for LC.

Primary and secondary outcome measures: Mean knowledge, attitudes, practices, and lifestyle scores were assessed using an investigator-designed questionnaire completed by patients during immunotherapy.

Results: The study included 402 participants. The mean knowledge, attitudes, practices and lifestyle scores were 6.60±3.51 (/10, 66.00%), 41.26±5.06 (/50, 82.52%), 30.74±4.20 (/40, 76.85%) and 42.37±6.04 (/55, 77.04%), respectively. Attitude scores were associated with practice scores (β=0.381, p<0.001) and lifestyle (β=1.928, p<0.001). Urban residence was associated with higher attitude scores (β=1.242, p=0.013). Living with someone was associated with a higher attitude score (β=1.619, p=0.044). More than one immunotherapy line was associated with a higher lifestyle score (β=1.928, p<0.001). Finally, the female gender was associated with a lifestyle score (β=1.431, p=0.023).

Conclusion: Patients with LC and undergoing immunotherapy had moderate KAP towards irAEs and nutritional support. They also displayed moderate lifestyle scores. Urban residents, people not living alone, females and those having received two or more immunotherapy treatments were positively associated with attitude, while attitude was positively associated with practice and lifestyle.