Table 1.
Evidence-based guideline recommendations and adherence criteria.
| Nutrition Care Framework | Recommendation | NHMRC a Grade |
Adherence Criteria |
|---|---|---|---|
| Access to Care Screening and Assessment |
• Malnutrition screening should be undertaken on all patients at diagnosis to identify nutritional risk and then repeated at intervals through each stage of treatment (e.g., surgery, radio/chemotherapy and post-treatment). | B | • Screening using the MST b occurred before Week 1 of radiotherapy. |
| • All patients receiving radiotherapy to the head and neck should be referred to the dietitian for nutrition support. | B | • Dietetic consult occurred before Week 1 of radiotherapy. | |
| • Use a validated nutrition screening tool (e.g., MST) for identifying malnutrition risk. | B | • Use of the MST occurred before Week 1 of radiotherapy. | |
| • Use a validated nutrition assessment tool (e.g., PG-SGA c). | B | • Use of PG-SGA occurred when assessing nutritional status. | |
| Quality Nutrition Care | • Weekly dietitian contact improves outcomes in patients receiving radiotherapy. | A | • Dietetic consult occurred for every five fractions of radiotherapy given in a single working week period. |
| Nutrition Monitoring and Evaluation | • Patients should be seen weekly by a dietitian during radiotherapy. | A | • As above. |
| • Patients should receive minimum fortnightly follow up by a dietitian for at least 6 weeks post-treatment. | A | • Dietetic consult occurred at least once in a 14 day period following end of radiotherapy for three consecutive fortnights. | |
| • Monitor weight, intake and nutritional status during and post-(chemo)radiotherapy. | A | • Use of Scored PG-SGA occurred at baseline, mid-RT d (Week 3–4), end-RT (Week 6–7) and at post-RT dietitian consults. |
a NHMRC = National Health and Medical Research Council; b MST = Malnutrition Screening Tool; c PG-SGA = Patient-Generated Subjective Global Assessment; d RT = radiotherapy.