TELEMEDICINA: ESTADO NUTRICIONAL Y TOLERANCIA AL TRATAMIENTO QUIMIOTERÁPICO EN PACIENTES DOMICILIARIOS

Abstract

Introduction: Malnutrition affects 40 to 70% of cancer patients increasing morbidity and mortality, decreasing quality of life and worsening response to treatments. Home chemotherapy is an effective patient centered strategy. Telemedicine is essential in the home care setting. Objectives: To determine the nutritional status of oncological patients in home chemotherapy and the relationship between nutritional status and adverse effects and tolerance to treatment. Methods: Observational, descriptive, and longitudinal study between March and October 2020. We included patients with diagnosis of cancer who received home treatment. The routes of administration were intravenous, intramuscular, subcutaneous and intravesical. Nutritional screening was performed using NutriScore ®. Variables Age, sex, diagnosis, nutritional status, route of administration, tolerance, intake, nutritional intervention, previous nutritional support. Descriptive statistical analysis and correlation between Nutritional Status and tolerance and adverse effects (Fisher's Test) were performed. Results: We included 105 patients (67 men), average age 67.7 years. Thirty presented nutritional risk. At baseline, 3 patients received nutritional support (2 oral and 1 parenteral). 836 chemotherapy sessions were performed. Tolerance: 621 (74.3%) very good; 151 (18%) good; 50 (6%) regular and 14 (1.7%) bad. Intake: Average 1517 calories / day. Of the 105 patients, 40 had adverse event, mainly digestive. One patient stopped treatment due to intolerance. Correlation between nutritional status and adverse events: no statistically significant differences. Correlation between Nutritional Status and tolerance: statistically significant association. Conclusion: Malnutrition is a frequent condition in cancer patients; high nutritional risk is related to lower tolerance to treatments. The implementation of remote nutritional care programs allows early detection of changes in nutritional status. Key words: Home chemotherapy; Telemedicine; nutritional support; cancer; malnutrition.