All patients are given a nutritional screening as they start on the Prehab4Cancer programme. This is delivered as part of their baseline assessment by their exercise specialist, who have all completed additional training in nutritional screening. The service is currently transitioning to using the PG-SGA (Patient Generated Subjective Global Assessment) as its primary nutritional screening tool.
The team rely on baseline nutrition information from being provided by the referring team, via the GP.
What?
Weight (weekly)
Weight trend (loss or gain) – automatically populated
Body Mass Index (BMI) – automatically populated
Handgrip (research)
Changes in ability to swallow solid food, appetite and level of food intake
When?
Colorectal/lung – start and end prehab (2 assessments)
UGI – start of prehab, middle (end of chemo) and end of prehab (3 assessments)
How?
Database to record data and track changes
Questioning
A flag system based on nutritional risk identified within screening tool is used.
Low Risk
Participant provided with bespoke P4C nutrition leaflet (exercise + healthy eating) and continued to have weight monitored
Moderate Risk
Participant provided with Christie ‘Eating help yourself’ comprehensive booklet and continued to be monitored – increased frequency
High Risk
Contact made to clinical team for CNS or Dietician to provide dietetic counselling. Alternatively patient can liaise with own Dietician in community or hospital (if they have one) or referral to community Dietician via. GP. Clinical team to be made aware. Consider whether to adapt or terminate intensive exercise programme.
| Nutritional Risk | Risk Alerts | PT Action | |
|---|---|---|---|
| Action Plan 1 | Low | None | Continue to monitor patient |
| Action Plan 2 | Medium | One of the following:
>5% weight loss in the past month Drop in IDDSI level Drop in foot intake to <75% of normal |
Give diet sheet “Eating to help yourself”
Increase monitoring |
| Action Plan 3 | High | One of the following:
BMI <20kg/m2 >10% weight loss past 3-6/12 Two of the following: >5% weight loss in past month Drop in IDDSI level Drop in food intake to <75% of normal |
Give diet sheet – “Eating to help yourself”
Highlight concerns to parent team / CNS Patient to contact dietitian if known. |
