Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Perspectives of patients with advanced pancreatic cancer regarding a proposed intensive nutrition intervention: A qualitative investigation  (#457)

Grace Nguyen 1 , Daniel Croagh 2 3 , Terry Haines 4 , Catherine E Huggins 5 , Lauren Hanna 6 , Kate Furness 7
  1. Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, Melbourne University, Parkville, Victoria, Australia
  2. Upper Gastrointestinal and Hepatobiliary Surgery Unit, Monash Medical Centre, Monash Health, Clayton, Victoria, Australia
  3. Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
  4. School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia
  5. Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
  6. Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
  7. Department Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia

Aims: Malnutrition is highly prevalent in pancreatic cancer (PC), and is associated with poor quality of life (QOL). A planned randomised controlled trial (RCT), ‘Supplemental Enteral Nutrition to Improve Quality of Life (SuperQoL)’ in advanced PC patients, will investigate the effect of delivering top-up nutrition via percutaneous endoscopic gastrostomy with jejunal extension (PEG-J). This will be supported by intensive dietetic counselling delivered via telehealth. The present study aims to determine the acceptability of this intervention to elucidate appropriateness, anticipated barriers to uptake, and facilitate informed co-design with patients.  

Methods: Patients with PC who consented to future research with the Pancreatic Cancer Biobank were recruited for semi-structured interviews using random sampling. Information power was used to assist with sample size determination, where lower numbers of participants are required when more relevant information is held by the sample. The Theoretical Framework of Acceptability was used as the analytical framework.  

Results: Ten PC participants were recruited to the study. Five overarching themes were developed from interviews: 1) debilitating nutrition impact symptoms are a barrier to maintaining adequate nutrition; 2) willingness to participate depends upon an individual threshold for nutritional deterioration; 3) supplementary enteral feeding is anticipated to be effective and beneficial; 4) predicted perceived effectiveness outweighs financial burden and 5) adequate dietetic support is needed for maintaining a PEG-J at home with confidence.  

Conclusions: Most participants believed that the intervention would benefit people diagnosed with advanced PC to maintain their nutrition throughout palliative chemotherapy and reduce the distress of trying to eat and drink adequately. Regular and ad hoc support was considered essential for effectiveness. The deterioration of an individual’s nutrition status was an important indicator for willingness to participate, which may be a barrier to recruitment. Design of the RCT protocol will aim to encompass solutions to overcome these factors, to minimise recruitment and adherence challenges and increase the interventions’ acceptability.

  1. Lauren Hanna and Kate Furness are joint senior authors