Cancer-malnutrition care beyond the hospital walls: a survey of nutrition governance, practice, knowledge and education needs in the primary care and community sector

Abstract Purpose: Cancer-related malnutrition remains a prevalent issue in cancer survivorship. This study aimed to understand cancer-related malnutrition practice, knowledge and education needs in the primary care and community sectors, as well as the transition of nutrition care from hospital cancer services following cancer treatment. Methods: A cross-sectional survey was conducted with general practitioners (GPs), general practice nurses (GPNs) and dietitians in hospital cancer services, community services and primary care in Victoria, Australia.Results: The 184 respondents represented dietitians (n=152), GPs (n=22) and GPNs (n=10). GPs and GPNs, and dietitians working in primary care and community settings (78% and 63%, respectively) agree cancer malnutrition is going unrecognised in their service. Only 26% of community health services complete malnutrition risk screening and 35% of GPs and GPNs frequently weigh their patients with cancer. Most GPs and GPNs (88%) believe responsibility for malnutrition risk screening should be shared across disciplines and 94% would like access to a malnutrition screening tool. Only 32% of hospital oncology dietitians and 44% of GPs and GPNs frequently refer their patients to primary care or community dietitians.Conclusion: Implementation of routine malnutrition risk screening in primary care and community services and improved transition of nutrition care between hospital, primary care and community practitioners is required. Targeted cancer malnutrition education and resources across all health sectors is warranted.Implications for cancer survivors: Barriers to identification and management of cancer-related malnutrition in primary and community care should be addressed to improve transition of care.