Background
Patients with cancer are often referred to dietitians based on the Malnutrition Screening Tool (MST). Malnutrition rates are high in this cohort, and early dietetic intervention can improve outcomes. At our regional hospital oncology day unit, we have identified that current referrals to our outpatient dietetic service is often delayed, and routine malnutrition screening is not always completed. Patient-led malnutrition screening can alleviate the pressure on staff to complete patient screening and improve patient autonomy in healthcare. While prior studies suggest patient-led screening in the oncology outpatient setting is reliable, its uptake and impact on referral timeliness compared to traditional methods remains unclear.
Methods
An iPad with an electronic MST was introduced into our regional hospital’s oncology day unit. All medical oncology patients attending appointments were invited to complete screening. Patients who screened at risk of malnutrition, were asked if they consented to dietitian referral. Responses were monitored by the oncology dietitian. From this list, completion rates, MST scores and consent were reviewed. Additionally, the number of days and weight loss before dietitian referral was compared between patients referred via the self-screening tool and those referred through traditional methods prior to implementation.
Results
Completion rates for the self-screening tool were low (<10%). Of the patients who self-screened, thirty percent(15/49) were identified as at-risk, with 55% (8/15) consenting to a referral.*results re timeliness TBC*
Conclusion
Our results highlight that even with low completion rates, our self-screening tool identified at-risk patients. This reduces administration tasks for staff and may identify patients at risk of malnutrition that are not referred by standard methods. At this stage, self-screening should not replace clinician-led screening, but rather they can co-exist to optimise identification of at-risk patients. Further research is needed to explore barriers to engagement with self-screening and understand reasons for declining dietitian services.