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Frances Dobson and Natasha Jones, Haematology Dieticians at Addenbrookes Hospital, explain their role in managing the dietetic needs of myeloma patients.
How are referrals made, and what does the service offer to patients?
Referrals are normally made through the hospital’s Epic IT system, but can be made face-to-face on the ward or via email. We get referrals from the outpatient department, inpatient wards and the day unit. All community patients who remain under the care of our myeloma consultants will remain under the care of Cambridge University Hospital’s haematology dietitians instead of being referred to their local community dietitian. This has enabled closer MDT working. If space is unavailable to review patients in clinic then we will review them on the day unit or failing that offer a telephone review. Patients may contact us via MyChart or email with any queries or concerns in-between reviews.
Our dietetic service involves:
-Assessing and supporting nutritional adequacy throughout treatments providing oral and enteral tube feeding to prevent/treat weight and muscle loss
-Using dietary methods to support symptom management such as nausea, constipation, mucositis and taste changes.
-Proactively optimising nutritional status prior to treatments such as stem cell transplants and radiotherapy
-Providing dietary advice to support rehabilitation, functional status and quality of life
We have seen a rise in the number of referrals received as more members of the myeloma team become aware of the impact nutritional support makes to their patients’ clinical outcomes, quality of life and fitness for treatment. We are providing more proactive treatments often in the form of tube feeding for patients. As our referral numbers increase, we are actively looking for further funding so we can expand the dietetic service for the haematology team.
What impact has the service had on patients, families/carers and colleagues?
One of the main achievements of the service is to avoid hospital admission, which has been possible due to the proactive approach of our MDT that promotes early dietetic input. This has led to referrals being made before patients become malnourished and before starting their treatment. Being proactive rather than reactive has been effective in improving the quality of life of myeloma patients.
From a personal perspective, it feels great to be part of a team that is pro-nutrition, and that acts quickly. Patients can be seen for long periods by the dietetics team, and being easily contactable has helped us to build good relationships with patients. It’s exciting that you can make such a difference to patient’s lives.
Can you offer any advice for other hospitals wanting to provide a dietetics service?
Liaising with the consultants and CNS teams is very important when promoting funding for a business case. Providing education to the team on the importance of nutrition in myeloma can promote awareness. Completing an audit to identify the number of patients that meet referral criteria for dietetic input would inform on the dietetic service required for the patient cohort.
Frances Dobson and Natasha Jones
Haematology Dieticians
Addenbrooke’s Hospital
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