Patient characteristics and nutrition interventions among referrals to outpatient registered dietitians in a tertiary cancer center: Retrospective analysis.

Abstract

e13587 Background: Malnutrition in cancer patients is linked to diminished functional capacity, greater treatment toxicity, longer hospital stays, reduced quality of life, and shorter survival. Interventions by Registered Dietitian Nutritionists (RDNs) can improve treatment adherence, QOL, and weight stability. Atrium Health Levine Cancer established the Section of Oncology Nutrition in 2016. Fifteen clinical RDNs and two Wellness RDNs across 23 locations, completing over 16,000 annual encounters. We describe characteristics and nutrition interventions of cancer patients referred to outpatient RDN consult. Methods: Inclusion: age ≥18 years, newly diagnosed, and initial RDN consultation between 2023 and 2024. Referrals were initiated via a Malnutrition Screening Tool (MST) score ≥2 or direct clinician referral. Data from electronic medical records were matched with the Cancer Registry. Descriptive statistics summarize patient characteristics and nutrition interventions. Results: 2,243 consultations were matched with the Cancer Registry. Median age was 65, 47% were female, 70% White, 25% Black, and 5% Latino. Most were married (55%) and on Medicare (50%). Eight percent were underweight, 38% normal weight, and 54% overweight or obese. Gastrointestinal (27%), head and neck (18%), lung (14%) cancers were most common. Fifty-seven percent had stage III-IV disease. Twenty-six percent received RDN consultation within 30 days of diagnosis. Fifty-three percent had an MST score of ≥2. Following RDN consultation, 92% had a nutrition-related diagnosis including: inadequate oral intake (27%), unintended weight loss (17%), and predicted inadequate energy intake (14%). Most frequent interventions included nutrition education (63%), medical supplements (54%), and diet modification (26%). Conclusions: Comprehensive RDN evaluations revealed significant nutrition-related needs, highlighting the importance of early and proactive nutrition care in cancer. Most patients were referred to RDN ≥30 days after diagnosis underscoring barriers to early referrals. The MST underestimated the prevalence of nutrition-related problems, and most patients were overweight or obese.