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      Definition and assessment of adherence to oral nutritional supplements in patients with neoplasms: a scoping review

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          Abstract

          Introduction

          Cancer remains a leading cause of death globally, with patients frequently experiencing malnutrition due to both the disease and its treatment, which negatively affects their quality of life and treatment outcomes. Oral nutritional supplements (ONS) provide a noninvasive solution to improve nutritional status, but poor patient adherence limits their effectiveness. Studies on ONS adherence vary in their definitions and assessment tools, creating inconsistencies. A scoping review is essential to synthesize these studies and establish a foundation for future research and clinical practice.

          Method

          We systematically searched six databases, including Web of Science, PubMed, and Scopus, up to August 2024. Our criteria focused on oncology patients, ONS interventions, and outcomes related to adherence definitions, assessment methods, and adherence rates.

          Results

          37 studies from 2005 to 2024 met the inclusion criteria. Definitions of ONS adherence and assessment methods vary widely, with the most common definition being the ratio of actual intake to the recommended amount. The assessment tools included self-reported ONS diaries, and MMAS scores, among others. Adherence rates also vary significantly, with some studies reporting a decline in adherence over time.

          Conclusion

          The lack of standardized definitions and assessment methods for ONS adherence across studies hinders comparability. Future research should focus on developing standardized, comprehensive adherence assessment tools that incorporate both quantitative and qualitative data. This would allow for a better understanding of adherence factors and enable more targeted interventions to improve long-term adherence in cancer patients.

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          Most cited references69

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          Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article presents global cancer statistics by world region for the year 2022 based on updated estimates from the International Agency for Research on Cancer (IARC). There were close to 20 million new cases of cancer in the year 2022 (including nonmelanoma skin cancers [NMSCs]) alongside 9.7 million deaths from cancer (including NMSC). The estimates suggest that approximately one in five men or women develop cancer in a lifetime, whereas around one in nine men and one in 12 women die from it. Lung cancer was the most frequently diagnosed cancer in 2022, responsible for almost 2.5 million new cases, or one in eight cancers worldwide (12.4% of all cancers globally), followed by cancers of the female breast (11.6%), colorectum (9.6%), prostate (7.3%), and stomach (4.9%). Lung cancer was also the leading cause of cancer death, with an estimated 1.8 million deaths (18.7%), followed by colorectal (9.3%), liver (7.8%), female breast (6.9%), and stomach (6.8%) cancers. Breast cancer and lung cancer were the most frequent cancers in women and men, respectively (both cases and deaths). Incidence rates (including NMSC) varied from four‐fold to five‐fold across world regions, from over 500 in Australia/New Zealand (507.9 per 100,000) to under 100 in Western Africa (97.1 per 100,000) among men, and from over 400 in Australia/New Zealand (410.5 per 100,000) to close to 100 in South‐Central Asia (103.3 per 100,000) among women. The authors examine the geographic variability across 20 world regions for the 10 leading cancer types, discussing recent trends, the underlying determinants, and the prospects for global cancer prevention and control. With demographics‐based predictions indicating that the number of new cases of cancer will reach 35 million by 2050, investments in prevention, including the targeting of key risk factors for cancer (including smoking, overweight and obesity, and infection), could avert millions of future cancer diagnoses and save many lives worldwide, bringing huge economic as well as societal dividends to countries over the forthcoming decades.
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            Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses.

            Medication compliance is one of the foremost problems affecting neuroleptic efficacy in psychiatric patients. To date, compliancy has most commonly been assessed with the Drug Attitude Inventory (DAI) developed by Hogan et al. (Hogan, T.P., Awad, A.G., Eastwood, R., 1983. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychol. Med. 13, 177-183). The present study identified several deficiencies in the DAI. Using the partial credit version of the Item Response Theory measurement model, the DAI was refined with the aim of greater validity and clinical utility. The new inventory was administered to 66 patients, the majority of whom were diagnosed with schizophrenia. When available, lithium levels and carer ratings of compliance were also recorded and used to verify compliancy. The new inventory appears to be a valid and reliable measure of compliancy for psychoactive medications.
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              A randomized phase II feasibility trial of a multimodal intervention for the management of cachexia in lung and pancreatic cancer

              Abstract Background Cancer cachexia is a syndrome of weight loss (including muscle and fat), anorexia, and decreased physical function. It has been suggested that the optimal treatment for cachexia should be a multimodal intervention. The primary aim of this study was to examine the feasibility and safety of a multimodal intervention (n‐3 polyunsaturated fatty acid nutritional supplements, exercise, and anti‐inflammatory medication: celecoxib) for cancer cachexia in patients with incurable lung or pancreatic cancer, undergoing chemotherapy. Methods Patients receiving two cycles of standard chemotherapy were randomized to either the multimodal cachexia intervention or standard care. Primary outcome measures were feasibility assessed by recruitment, attrition, and compliance with intervention (>50% of components in >50% of patients). Key secondary outcomes were change in weight, muscle mass, physical activity, safety, and survival. Results Three hundred and ninety‐nine were screened resulting in 46 patients recruited (11.5%). Twenty five patients were randomized to the treatment and 21 as controls. Forty‐one completed the study (attrition rate 11%). Compliance to the individual components of the intervention was 76% for celecoxib, 60% for exercise, and 48% for nutritional supplements. As expected from the sample size, there was no statistically significant effect on physical activity or muscle mass. There were no intervention‐related Serious Adverse Events and survival was similar between the groups. Conclusions A multimodal cachexia intervention is feasible and safe in patients with incurable lung or pancreatic cancer; however, compliance to nutritional supplements was suboptimal. A phase III study is now underway to assess fully the effect of the intervention.
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                Author and article information

                Contributors
                1585470513@qq.com
                Journal
                BMC Cancer
                BMC Cancer
                BMC Cancer
                BioMed Central (London )
                1471-2407
                2 December 2024
                2 December 2024
                2024
                : 24
                : 1483
                Affiliations
                [1 ]GRID grid.415880.0, ISNI 0000 0004 1755 2258, School of Medicine, , University of Electronic Science and Technology of China, Sichuan Cancer Hospital, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, ; Chengdu, China
                [2 ]GRID grid.415880.0, ISNI 0000 0004 1755 2258, Comprehensive Department, , Sichuan Cancer Hospital, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, ; Chengdu, China
                [3 ]GRID grid.415880.0, ISNI 0000 0004 1755 2258, Department of Radiation Oncology, , Sichuan Cancer Hospital, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, ; Chengdu, China
                [4 ]Department of Head and Neck Radiation Oncology, Sichuan Cancer Hospital, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, ( https://ror.org/029wq9x81) Chengdu, China
                [5 ]GRID grid.190737.b, ISNI 0000 0001 0154 0904, Department of Vascular and Interventional Medicine, Chongqing Cancer Hospital, , Affiliated Cancer Hospital of Chongqing University, ; Chongqing, China
                Article
                13237
                10.1186/s12885-024-13237-y
                11610086
                39623358
                c5b214b9-a0d2-4a62-a524-2d7072506bad
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

                History
                : 8 September 2024
                : 25 November 2024
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2024

                Oncology & Radiotherapy
                neoplasm,oral nutritional supplementation,adherence,assessment,definition
                Oncology & Radiotherapy
                neoplasm, oral nutritional supplementation, adherence, assessment, definition

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