Nutrition & Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.
Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.
Int J Environ Res Public Health. 2022 Mar 29;19(7):4038. doi: 10.3390/ijerph19074038.
Cancer-related sarcopenia is a complex condition; however, no cancer-specific clinical model is available to guide clinical practice. This study aims to (1) develop an evidence-based care pathway for the management of cancer-related sarcopenia ("sarc-pathway") and (2) pilot test the feasibility (reach, intervention fidelity, patient and clinician acceptability) of the sarc-pathway in an inpatient cancer ward. The sarc-pathway was developed using a care pathway format and informed by the current literature. Patients admitted to a 32-bed inpatient cancer ward were recruited to receive sarc-pathway care and the feasibility outcomes were assessed. Of the 317 participants admitted, 159 were recruited over 3.5-months (median age 61 years; 56.0% males). Participant consent was high (99.4% of those approached) and 30.2% were at risk of/had sarcopenia. The sarc-pathway screening, assessment and treatment components were delivered as intended; however, low completion of clinical assessment measures were observed for muscle mass (bioimpedance spectroscopy, 20.5%) and muscle function (5-times chair stand test, 50.0%). The sarc-pathway was demonstrated to be acceptable to patients and multidisciplinary clinicians. In an inpatient cancer ward, the sarc-pathway is a feasible and acceptable clinical model and method to deliver and adhere to the sarcopenia clinical parameters specified, albeit with further exploration of appropriate clinical assessment measures.
癌症相关的肌肉减少症是一种复杂的病症；然而，目前尚无针对这种病症的特定临床模型可供临床实践参考。本研究旨在：(1) 制定一种基于证据的癌症相关肌肉减少症管理护理途径（“肌肉减少症途径”）；(2) 在一个住院癌症病房中对肌肉减少症途径的可行性（可及性、干预忠实度、患者和临床医生的可接受性）进行试点测试。肌肉减少症途径采用护理途径格式制定，并参考了当前的文献。将入住 32 张病床的住院癌症病房的患者纳入该途径，以接受肌肉减少症途径的护理，并评估可行性结果。在 317 名入院患者中，有 159 名在 3.5 个月内被招募（中位年龄 61 岁；56.0%为男性）。参与者的同意率很高（有意愿的参与者中有 99.4%同意），其中 30.2%有肌肉减少症风险/已患有肌肉减少症。肌肉减少症途径的筛查、评估和治疗部分按计划实施；然而，肌肉质量（生物电阻抗谱法，20.5%）和肌肉功能（5 次椅子站立测试，50.0%）的临床评估措施的完成率较低。肌肉减少症途径被证明是患者和多学科临床医生都可接受的。在住院癌症病房中，肌肉减少症途径是一种可行且可接受的临床模型和方法，可以按照规定提供和遵循肌肉减少症的临床参数，尽管还需要进一步探索合适的临床评估措施。
