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. 2024;20(25):1825-1836.
doi: 10.1080/14796694.2024.2341576. Epub 2024 Jun 12.

Current and anticipated future state of cachexia care in patients with cancer

Aaron H Chevinsky  1 , John Goodman  2 , Jackie Risco  3 , Alexandra Marrinan-Duke  3 , Lisa Tarasenko  4 , Ira A Jacobs  4
Affiliations

Current and anticipated future state of cachexia care in patients with cancer

Aaron H Chevinsky et al. Future Oncol. 2024.

Abstract

Aims: We assessed care in cancer patients with cachexia across leading health systems (LHSs).Patients & methods: Qualitative interviews and quantitative surveys were conducted with LHSs executives and frontline health care personnel, representing 46 total respondents and 42 unique LHSs and including oncology service line leaders, supportive care services, dietitians and surgical oncologists.Results: Cachexia was not considered a top priority, and formal diagnoses were rare. Participants highlighted the importance of addressing barriers to increase clinical trial enrollment and support frontline health care personnel and patients in early detection of cachexia.Conclusion: Cachexia prioritization needs to be elevated across LHSs executives to obtain capital and strategic imperatives to advance related care.

Keywords: cachexia; cancer; care delivery; care pathway; continuum of care; prevention; risk identification.

Plain language summary

[Box: see text].

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Conflict of interest statement

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Figures

Figure 1.
Figure 1.
Current state of cachexia care pathways across leading health systems: framework for lifestyle changes, case reviews and home care. GI: Gastrointestinal; LHS: Leading health system. Reprinted with permission from The LHSs Approach to Cachexia Care in Cancer Patients. ©The Health Management Academy March 2022, with permission from The Health Management Academy.
Figure 2.
Figure 2.
The profiles of participating health systems, executives, and frontline healthcare personnel from survey responses and qualitative insights from executives at leading health systems. Most of the findings regarding the role of dietitians/nutritionists were obtained from the interview process. All data and findings are reflective of survey responses and qualitative insights from executives at LHSs. The sample size remained consistent throughout the assessment, in which quantitative survey responses (n = 41) and qualitative perspectives (n = 15) were aggregated to represent 42 unique health systems. AMC: Academic medical center; APP: Advanced practice provider; HCP: Healthcare personnel; LHS: Leading health system; NPR: Net patient revenue. Reprinted with permission from The LHSs Approach to Cachexia Care in Cancer Patients. ©The Health Management Academy March 2022, with permission from The Health Management Academy.
Figure 3.
Figure 3.
Familiarization, prioritization, and decision-making for cachexia care across leading health systems, n = 41. CMO: Chief medical officer; CNO: Chief nursing officer; LHS: Leading health system. Reprinted with permission from The LHSs Approach to Cachexia Care in Cancer Patients. ©The Health Management Academy March 2022, with permission from The Health Management Academy.
Figure 4.
Figure 4.
Barriers to diagnosis of cachexia and triggers for intervention across leading health systems, n = 18. LHS: Leading health system. Reprinted with permission from The LHSs Approach to Cachexia Care in Cancer Patients. ©The Health Management Academy March 2022, with permission from The Health Management Academy.
Figure 5.
Figure 5.
Initiatives across leading health systems to support risk identification and care management. n = 41. EMR: Electronic medical record; LHS: Leading health system. Reprinted with permission from The LHSs Approach to Cachexia Care in Cancer Patients. ©The Health Management Academy March 2022, with permission from The Health Management Academy.
Figure 6.
Figure 6.
Barriers to timely intervention in the management of cachexia across leading health systems. LHS: Leading health system. Reprinted with permission from The LHSs Approach to Cachexia Care in Cancer Patients. ©The Health Management Academy March 2022, with permission from The Health Management Academy.
Figure 7.
Figure 7.
Factors influencing the relative importance of cachexia in patients with cancer from the leading health system perspective. n = 41. EMR: Electronic medical record; LHS: Leading health system. Reprinted with permission from The LHSs Approach to Cachexia Care in Cancer Patients. ©The Health Management Academy March 2022, with permission from The Health Management Academy.
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References

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