Aims:
Cancer malnutrition is common and associated with poor clinical and functional outcomes. The Malnutrition in Victorian Cancer Services (MVCS) program of work conducted from 2011-2017 (phase I-III) is a state-wide collaboration between Peter MacCallum Cancer Centre, the Victorian state government and 14 Victorian health services. The MVCS projects aimed to increase understanding, raise knowledge and promote strategies for action in order to address cancer malnutrition.
Methods:
MVCS projects consisted of a malnutrition point prevalence study (PPS), clinician survey, health service survey, coding analysis, consumer education material development (phase I); repeat PPS, 2 state-wide and 17 local initiatives that targeted identified areas of need (phase II); 5 state-wide initiatives including a repeat PPS (phase III).
Results:
Phase I established the extent of cancer malnutrition and highlighted service gaps. Phase II included the development of eLearning packages targeting cancer care clinicians, a nutrition governance toolkit for practical health service application, and completion of 17 local health service initiatives. Phase III included 5 targeted state-wide projects focused on the sustainability of resources developed in phase II, how to improve methods of malnutrition screening in culturally and linguistically diverse populations and an evaluation of patient food service models to best support improving nutrition care. A malnutrition PPS was conducted in each phase and demonstrated a state-wide reduction in malnutrition prevalence from 31% in 2012 (n=1693) to 26% in 2014 (n=1913) and 25% in 2016 (n=1351).
Conclusions:
State-wide collaboration has led to improvements in clinical outcomes through sharing and supporting implementation of best practice nutrition approaches, the delivery of new models/pathways of care and improved multidisciplinary awareness of cancer malnutrition. This work has helped to reduce variation across the state and equip health services with tools to more effectively care for patients burdened by cancer malnutrition.