Objectives/purpose
To explore factors that predict referral to a dietitian or nutritionist and understand if there is an association between access to expert nutrition care and dietary change among people receiving cancer treatment in a regional healthcare system.
Sample and setting
Adults (18+) who completed cancer treatment within the last five years in South West region of Western Australia.
Procedures
Participants were invited to complete an online survey between September 2023 and July 2024, designed to understand people’s experience of receiving supportive care during cancer treatment. Descriptive summaries were used for quantitative data and logistic regression was used to identify independent predictors of dietitian/nutritionist referral and dietary change.
Results
Ninety-seven participants were included. Thirty-five percent (n=34) of participants reported accessing a dietitian or nutritionist via a referral. Low-malnutrition risk cancers (e.g. breast, prostate) were significantly less likely to receive a referral than high-malnutrition risk cancers (e.g. head and neck) (OR=6.46, 95% CI 2.34-17.86, p<0.001). Age, gender, and insurance status were not significantly associated with referral to a dietitian or nutritionist. Participants who received care from a dietitian or nutritionist had approximately 10 times higher odds of making dietary changes (OR=10.21, 95% CI 2.29-45.30, p<0.002) than those who received guidance from a non-nutrition health professional or the internet. Personal choice was the primary enabler to dietary change (64%) whereas beliefs that dietary changes were unnecessary (35%) and treatment side effects (32%) were common barriers.
Conclusion and clinical implications
This study revealed differences in access to expert nutrition care based on cancer diagnosis. There was an increased likelihood of dietary change among people receiving care from a dietitian or nutritionist, emphasising the role of nutrition professionals in cancer care. Improved referral practices, particularly for low-risk cancers, are required to enhance equity of care in regional Western Australia.