Examining Access to Nutrition Care
in Outpatient Cancer Centers
Proceedings of a Workshop
Leslie Pray and Ann L. Yaktine, Rapporteurs
Food and Nutrition Board
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by the Academy of Nutrition and Dietetics (AND), Alcresta, Inc., the American Cancer Society, the American Institute for Cancer Research, the AND Foundation, The Annie Appleseed Project, the Clinical Nutrition Management Dietetics Practice Group of the AND, Medtrition, the National Cancer Institute, the National Institutes for Health (NIH), the NIH Office of Dietary Supplements, the Oncology Nutrition Dietetic Practice Group of the AND, OptionCare, and Savor Health. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-44585-6
International Standard Book Number-10: 0-309-44585-X
Digital Object Identifier: 10.17226/23579
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Copyright 2016 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2016. Examining access to nutrition care in outpatient cancer centers: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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PLANNING COMMITTEE ON ASSESSING RELATIONSHIPS BETWEEN ACCESS TO STANDARDIZED CARE AND HEALTH OUTCOMES AND COST-EFFECTIVENESS OF CARE IN OUTPATIENT CANCER CENTERS1
CHERYL ROCK (Chair), Professor, Department of Family Medicine and Public Health, Cancer Prevention and Control Program, University of California, San Diego
KIM ROBIEN (Vice-Chair), Associate Professor, Exercise and Nutritional Science, Epidemiology and Biostatistics, The George Washington University
STEVEN K. CLINTON, Professor of Internal Medicine, Division on Hematology and Oncology, The Ohio State University
WENDY JOHNSON-ASKEW, Director of Public Policy, Nestlé Nutrition, North America
MARIAN NEUHOUSER, Member, Cancer Prevention Program, Public Health Services Division, Fred Hutchinson Cancer Research Center
NICO PRONK, Vice President for Health Management/Health Chief Officer, HealthPartners Institute
Health and Medicine Division Staff
ANN L. YAKTINE, Project Director and Director, Food and Nutrition Board
NOA NIR, Senior Program Assistant
Consultant
MEI CHUNG, Tufts University
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.
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Reviewers
This Proceedings of a Workshop has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published Proceedings of a Workshop as sound as possible and to ensure that the Proceedings of a Workshop meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this Proceedings of a Workshop:
Nancy J. Emenaker, National Cancer Institute
Kelly Kelleher, Nationwide Children’s Hospital
Colleen Spees, The Ohio State University College of Medicine
Cynthia Thomson, University of Arizona Cancer Center and Mel & Enid Zuckerman College of Public Health
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the Proceedings of a Workshop before its release. The review of this Proceedings of a Workshop was overseen by Nancy E. Adler, University of California, San Francisco. She was responsible for making certain that an independent examination of this Proceedings of a Workshop was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this Proceedings of a Workshop rests entirely with the rapporteurs and the institution.
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Contents
Organization of This Proceedings of a Workshop
2 CURRENT KNOWLEDGE AND STATUS OF NUTRITION PRACTICES IN ONCOLOGY OUTPATIENT CARE
Nutritional Interventions and Issues in Early Oncology Treatment
Nutritional Interventions and Issues in Long-Term Oncology Care
Panel Discussion with Speakers: Data Gaps in Current Nutrition Practice in Oncology Outpatient Care
3 MODELS OF CARE: NATIONAL AND INTERNATIONAL PERSPECTIVES
Nutrition Care for Oncology Outpatients: International Perspective
Panel Discussion with Speakers: Data Gaps in Models of Care
Perspectives on Oncology Nutrition Care: Employers and Other Purchasers
Panel Discussion with Speakers: Data Gaps in Outcomes and Costs of Care
5 DISSEMINATION AND IMPLEMENTATION: REACHING THE IDEAL
Dissemination and Implementation of Nutritional Care in Acute Care and Specialized Centers
Dissemination and Implementation of Nutritional Care in Community Settings
Developing Guidelines for Nutrition in Cancer Patients
Panel Discussion with Speakers: Data Gaps in Communication and Dissemination of Oncology Care
6 EVIDENCE ON NUTRITION CARE IN OUTPATIENT ONCOLOGY: CLOSING DISCUSSION
Tackling the Continuum of Care
Incorporating Nutrition Studies into Drug Clinical Trials
Determining the Value of Nutrition Services
B Biographical Sketches of Speakers and Moderators
C Additional References Used by the Planning Committee to Develop the Workshop
Acronyms and Abbreviations
ACCC |
Association of Community Cancer Centers |
ACO |
accountable care organization |
ACS |
American Cancer Society |
AICR |
American Institute for Cancer Research |
AND |
Academy of Nutrition and Dietetics |
ANDHII |
Academy of Nutrition and Dietetics Health Informatics Infrastructure |
ASCO |
American Society for Clinical Oncology |
ASTRO |
American Society for Radiation Oncology |
BMI |
body mass index |
CDHP |
consumer-driven health plan |
CDR |
Commission on Dietetic Registration |
CMMI |
Center for Medicare & Medicaid Innovation |
CMS |
Centers for Medicare & Medicaid Services |
CoC |
American College of Surgeon’s Commission on Cancer |
COE |
center of excellence |
COPD |
chronic obstructive pulmonary disease |
COSA |
Clinical Oncology Society of Australia |
CPT |
Current Procedural Terminology |
CSO |
Board Certified Specialist in Oncology Nutrition |
DIANA-5 |
Diet and Androgens-5 study |
DSHEA |
Dietary Supplement Health and Education Act of 1994 |
EAL |
Evidence Analysis Library |
ENERGY |
Exercise and Nutrition to Enhance Recovery and Good Health for You Trial |
FDA |
U.S. Food and Drug Administration |
FNCE |
Food and Nutrition Conference Expo |
FTE |
full-time equivalent |
GI |
gastrointestinal |
GP |
General Practitioner |
ICD |
International Classification of Diseases |
IEN |
immune-enhancing nutrition |
IOM |
Institute of Medicine |
NBGH |
National Business Group on Health |
NCCCP |
National Comprehensive Cancer Control Program |
NCCN |
National Cooperative Cancer Network |
NCI |
National Cancer Institute |
NEL |
U.S. Department of Agriculture’s Nutrition Evidence Library |
NIH |
National Institutes of Health |
NIS |
nutrition impact symptom |
ONDPG |
Oncology Nutrition Dietetic Practice Group |
PEG |
percutaneous endoscopic gastrostomy |
PG-SGA |
Patient Generated Subjective Global Assessment |
PIVOT |
Prostate Cancer Intervention Versus Observation Trial |
RCT |
randomized controlled trial |
RD |
registered dietitian |
RDN |
registered dietitian nutritionist |
RENEW |
Reach Out to ENhancE Wellness in Older Survivors |
SNAQ |
Short Nutritional Assessment Questionnaire |
WCRF |
World Cancer Research Fund International |
WHEL |
Women’s Healthy Eating and Living Study |
YMCA |
Young Men’s Christian Association |