Good clinical practice in the dietetic management of cancer patients - Theconsultation

Concert. The "Standards, Options and Recommendations" (SOR) project, starte d in 1993, is a collaboration between the Federation of the French Cancer C entres (FNCLCC), the 20 French Cancer Centres and specialists from French P ublic Universities, General Hospital and Private Clinics. The main objectiv e is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based o n literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. Objectives . To develop clinical practice guidelines according to the definitions of S tandards, Options and Recommendations for the dietetic consultation for can cer patients. Methods. Data have been identified by literature search using Medline and the expert groups personal reference lists. Once the guideline s were defined, the documents was submitted for review to 74 independent re viewers, and to the medical committees of the 20 French Cancer Centres. Res ults. The main recommendations for the refferral of cancer patients for die tary advice are: 1) in oncology, there are 3 types of dietetic consultation : diagnostic, preventative and therapeutic; 2) the following cancer patient s must have a dietetic consultation: i) those with, or at risk of malnutrit ion, ii) those without malnutrition but in need of counselling and iii) tho se at risk of treatment-related nutritional side effects; 3) a nutritional assessment is standard at the time of the first dietic consultation. Patien ts must be given individualised and written advice; 4) the dietetic opinion and advice should be brought to the attention of medical staff to facilita te a multidisciplinary approach to cancer treatment; 5) patient's relatives should be involved in the dietetic management; 6) the efficacy of dietetic advice can be assessed by monitoring weight, gastrointestinal signs and pa tients satisfaction.