INDICATIONS FOR HOME NUTRITIONAL SUPPORT IN CANCER … · Home artificial nutrition in cancer INDICATIONS FOR HOME CARE NUTRITION IN CANCER PATIENTS Winnie Magambo (United Kingdom)
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ESPEN Congress Florence 2008
Home artificial nutrition in cancer
INDICATIONS FOR HOME CARE NUTRITION IN
CANCER PATIENTS
Winnie Magambo (United Kingdom)
INDICATIONS FOR
HOME CARE
NUTRITION IN
CANCER PATIENTSWinnie Magambo
Clinical Nurse Specialist-Nutrition
University Hospital of Wales
Cardiff and Vale NHS Trust
AIMS
Indications for HETF
Indications for HPN
Practicalities of HETF/HPN
Summary
GOALS OF NUTRITIONAL
SUPPORT
Patients with advanced Cancer
Lessen side effects
Reduce risk of infection
Reduce loss of strength
Improve well-being
National Cancer Institute
INDICATIONS FOR HETF IN
CANCER PATIENTS
HETF IN CANCER PATIENTS
U.K figures
23% of HETF is for cancer patients
↑ proportion of cancer patients
GI cancers
↑ Head & Neck cancers
BANS Report 2007
INDICATIONS &
PRACTICALITIES FOR HEFT IN
CANCER PATIENTS
Cancer of the alimentary
canal
Complications from
chemotherapy/radiother
apy
PEG
RPG
JEJ
NG/NJ
PRACTICALITIES FOR HETF
Patient assessment
Home assessment
Training
Social & psychological wellbeing
Support at home
Follow up & Trouble shooting
HPN IN CANCER PATIENTS
% HOME PARENTERAL
NUTRITION IN CANCER
PATIENTS
40%-60% of HPN patients in U.S.A, Japan &
Italy
18% of HPN patients in France
5% of new HPN patients in U.K.
INDICATIONS FOR HPN IN
CANCER PATIENTS
Factors influencing indications
Disease process
Patient assessment
Decision making
Survival predictions
Timely referrals
Clinical assessments
INDICATIONS FOR HPN IN
CANCER PATIENTS
Nutritional criteria
Life expectancy
Quality of life
Functional Status
Home environment
Mirhosseini et al 2005
Initial assessment
Overall assessment
Re-evaluation of
treatment
European Association for Palliative
Care
PRACTICALITIES FOR HPN IN
CANCER PATIENTS
Patient assessment
Home assessment
Training
Social & psychological wellbeing
Support at home
Follow up & Trouble shooting
SUMMARY
Patient assessment
Predicted life expectancy
Quality of life
Social & psychological wellbeing
Follow-up mechanisms
Periodic evaluations home nutritional support
Patient focused & suited to their individual needs
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