Assessing the need for multimodal care in anorexia and cachexia patients with advanced cancer referred to palliative care: a secondary analysis of a multicenter survey in Japan.

PURPOSE: There are no methods for assessing the need for multimodal care in cancer cachexia. We examined nine components in evaluating needs among advanced cancer patients.

METHODS

This was a self-administered survey. Participants rated their nutrition impact symptoms (NISs) using a numerical rating scale, dietary intake using the Ingesta-Verbal/Visual Analogue Scale, and needs for nine components of multimodal care using a 7-point Likert scale. They completed the Hospital Anxiety and Depression Scale (HADS), Distress Thermometer, and Impact Thermometer questionnaires. They were divided into high- and low-need groups based on the median of the total scores for the nine components. We compared the groups and performed a multivariate logistic regression analysis to determine the association between need, NISs, dietary intake, and each scale.

RESULTS

Ultimately, 170 respondents were grouped into the high-need (n = 88) and low-need (n = 82) groups. There were no significant differences in their characteristics. The high-need group had significantly higher scores for NISs as well as higher HADS-Anxiety, Distress Thermometer, and Impact Thermometer scores. Four or more NISs with a score ≥ 4 (odds ratio (OR) 2.24, 95% confidence interval (CI) 1.09-4.60), a HADS-Anxiety score ≥ 8 (OR 2.42, 95% CI 1.22-4.79), a Distress Thermometer score ≥ 4 (OR 6.10, 95% CI 2.36-15.76), and an Impact Thermometer score ≥ 3 (OR 3.87, 95% CI 1.57-9.50) were associated with a high need.

CONCLUSIONS

The nine components were associated with NISs, anxiety, and distress. They were useful in evaluating needs for multimodal care.