Journal Article

Effects of integrative telehealth-based nutrition care with and without oral nutritional supplements in patients with liver and colorectal cancer: A randomized controlled trial

Yang, Suh-Ching, Chen, Yi-Hsiu, Wu, Ming-Shun, Chang, Wei-Chun

2025

Overview

This study investigated the effects of post-discharge integrative telehealth-based nutritional care alone versus post-discharge integrative telehealth-based nutritional care combined with high-calorie/high-protein oral nutritional supplements (HCHP-ONS) on the nutritional status and quality of life in patients with hepatocellular carcinoma (HCC) or colorectal cancer (CRC) at risk of malnutrition. We recruited HCC or CRC patients who were at moderate to high risk of malnutrition, defined as a score of 4–9 on the abridged Patient-Generated Subjective Global Assessment (aPG-SGA), and randomly assigned them to either a telehealth nutritional care-control group (C group) or a telehealth nutritional care combined with HCHP-ONS group (C+O group) for a 3-month intervention. In group C, a dietitian provided monthly telehealth-based nutritional assessments and guidance through a mobile application (LINE) or phone calls. In the C+O group, in addition to telehealth-based nutritional assessments and guidance, patients received a daily can of HCHP-ONS, which provided 425 kcal and 19.1 g of protein per serving. Blood tests, anthropometric indicators, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and a nutritional status assessment were conducted monthly. Results showed that the C+O group had significantly reduced malnutrition risk scores at the 1st, 2nd, and 3rd months. By the 3rd month, the C+O group showed significant improvement in the Prognostic Nutritional Index (PNI), and notable improvements in diarrhea and respiratory distress scores. In patients with HCC and CRC who were at risk of malnutrition, integrative telehealth-based nutritional care via LINE or phone calls effectively reduced malnutrition risk, maintained PNI, and supported quality of life (QOL). The addition of HCHP-ONS further enhanced nutritional outcomes, leading to greater improvements in PNI, diarrhea, and dyspnea by the 3rd month. •Telehealth nutrition care helped maintain nutritional status in cancer patients.•Adding high-calorie/high-protein oral nutritional supplements (HCHP-ONS) improved outcomes.•Telehealth nutrition care with HCHP-ONS reduced malnutrition risk.•Telehealth nutrition care with HCHP-ONS improved Prognostic Nutritional Index (PNI).•Telehealth nutrition care with HCHP-ONS alleviated diarrhea and dyspnea.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Aged / Applications programs / Assessments / blood / Cancer / Cancer therapies / Cancer-related malnutrition / Carcinoma, Hepatocellular - complications / Carcinoma, Hepatocellular - therapy / Chemotherapy / Clinical trials / Colorectal cancer / Colorectal carcinoma / colorectal neoplasms / Colorectal Neoplasms - complications / Colorectal Neoplasms - therapy / Counseling / Diarrhea / Dietary Supplements / Dietitians / distress / Dyspnea / Energy / Ethics / Fatty acids / Female / Hepatocellular carcinoma / hepatoma / Hospitals / Humans / Intervention / liver / Liver cancer / Liver Neoplasms - complications / Liver Neoplasms - therapy / Male / Malnutrition / Malnutrition - etiology / Malnutrition - prevention & control / Malnutrition - therapy / Medical prognosis / Middle Aged / Mobile computing / Nutrition Assessment / Nutrition therapy / Nutrition Therapy - methods / Nutritional Status / Oral nutrition supplements / Patients / Proteins / Quality of Life / questionnaires / randomized clinical trials / Respiration / Risk / Side effects / Telemedicine / Telephone calls