Adherence to Enteral Nutrition
ConditionEnteral Nutrition
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18-100
SponsorInstitut Curie
About this trial
Malnutrition is a major challenge in cancer nutrition, affecting approximately 40% of cancer patients and having negative consequences on treatment efficacy, quality of life, and prognosis. It must be detected and managed early, based on clinical and laboratory criteria defined by the HAS recommendations.
To address this, several nutritional strategies are available, ranging from fortified oral feeding to artificial nutrition. Enteral nutrition, which is more physiological and carries fewer risks than parenteral nutrition, is recommended as the first-line treatment. Tools such as personalized care plans and guidelines help tailor patient care.
However, enteral nutrition remains underutilized in clinical practice, despite the recommendations. The ADHENUTE study, conducted at the Institut Curie, showed low compliance with recommendations (31%) and a tendency to favor oral nutritional supplements, even in severely malnourished patients. The lack of traceability of decisions makes it difficult to identify barriers, although patient refusal is sometimes mentioned.
To improve this situation, corrective measures have been implemented:
* for patients, through educational workshops to help them better understand and accept enteral nutrition; * for healthcare providers, through training sessions to address reservations and enhance knowledge.
A third phase of the study aims to evaluate the impact of these actions, with the goal of increasing adherence to recommendations and the use of enteral nutrition.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Patients hospitalized (including those in the day hospital) in a medical oncology unit;
Adults;
Men or women;
Patients for whom enteral nutrition is indicated according to SFNCM recommendations;
Disqualifiers
Minors (under 18 years of age)
Patients receiving end-of-life palliative care
Individuals deprived of their liberty or under legal guardianship (including conservatorship);
Adults under judicial protection;
Trial population
We propose to conduct a prospective, single-center cohort study involving 80 patients. Patients will be enrolled at the Institut Curie in Saint Cloud over a 12-month period and followed for 6 months. Patients must be adults and hospitalized in a medical oncology ward.
Trial design
Design model
Cohort
Time perspective
Prospective
Treatments tested in this trial
Not listed
Trial groups
No trial groups listed
Trial outcomes
Primary outcomes
1
Assess compliance with recommendations for the implementation of enteral nutrition following the improvement measures implemented in Phase 2.
Percentage of patients for whom the recommendations are followed. Compliance with the recommendations will be assessed by comparing the recommended nutritional interventions with those actually implemented.
Time frame
From enrollment to the end of follow-up, which is 6 monthsSecondary outcomes
1
Assess the traceability of the reasons for not following a recommendation to initiate enteral nutrition in the patient's medical record
Percentage of cases detailing the reasons for exclusion from the nutrition program
Time frame
From enrollment to the end of follow-up, which is 6 months2
Assess the role of the dietetics department in screening for malnutrition and in the implementation of enteral nutrition
Percentage of patients treated by the dietetics department
Time frame
From enrollment to the end of follow-up, which is 6 months3
Assess the delay in initiating enteral nutrition
Percentage of weight loss (since the onset of the disease) among patients at the start of enteral nutrition
Time frame
Since the onset of the disease at the start of enteral nutrition4
Evaluate the implementation of recommendations based on tumor location
Percentage of patients for whom the recommendations are followed, by cancer site
Time frame
From enrollment to the end of follow-up, which is 6 monthsSponsors and contacts
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Source ClinicalTrials.gov