Palliative Care Team Involvement Is Associated with Changes in Nutrition Impact Symptoms and Eating-Related Distress in Patients with Advanced Cancer: A Multicenter Prospective Observational Study

Objectives: Evidence on the effects of palliative care team interventions on cachexia remains limited. We examined the effects on nutrition impact symptoms (NISs), dietary intake, and eating-related distress (ERD) among advanced cancer patients. Methods: This was a multicenter prospective observational study. Participants completed the baseline survey and the follow-up survey one week later. They evaluated NISs, dietary intake, and ERD. We compared the patient-reported outcomes between the two surveys. We categorized the participants having four or more NISs with a score ≥ 4 into the High-NIS group (otherwise, the Low-NIS group) using their baseline scores. Changes in the number of symptoms with a score ≥ 4, the dietary intake, and the ERD scores were calculated. Multiple regression analyses were performed to identify the factors influencing the improvements in dietary intake and ERD. Results: A total of 123 patients were included. In all patients, pain, fatigue, lack of appetite, sadness, and ERD significantly improved (p = 0.001, 0.023, 0.043, 0.037, <0.001). In the High-NIS group, the number of symptoms with a score ≥ 4 significantly decreased (p = 0.009), dietary intake scores significantly increased (p = 0.037), and ERD scores significantly decreased (p = 0.001). The number of symptoms with a score ≥ 4 at baseline (B = 1.08, p = 0.044, 95% confidence interval 0.03 to 2.14) was the only independent factor influencing the improvements in dietary intake. Conclusions: NISs and ERD improvements were associated with the interventions. Dietary intake improvement was associated with a high baseline symptom burden.