Factors influencing adherence to oral nutritional supplementation in patients with gastrointestinal neoplasms: a mixed methods systematic review
Objective To explore specific determinants influencing oral nutritional supplementation (ONS) adherence in gastrointestinal neoplasm patients. Methods This PROSPERO-registered (CRD42024611358) systematic review followed PRISMA 2020 guidelines. Databases including PubMed, Web of Science, and CNKI wer...
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| Published in | Supportive care in cancer Vol. 33; no. 9; p. 789 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.09.2025
Springer Nature B.V |
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| Online Access | Get full text |
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| Abstract | Objective
To explore specific determinants influencing oral nutritional supplementation (ONS) adherence in gastrointestinal neoplasm patients.
Methods
This PROSPERO-registered (CRD42024611358) systematic review followed PRISMA 2020 guidelines. Databases including PubMed, Web of Science, and CNKI were searched from inception to April 2025. Included studies underwent quality appraisal and integrative analysis using JBI mixed-methods guidelines.
Results
A total of 14 original studies were included, comprising 9 quantitative studies, 2 qualitative studies, and 3 mixed-methods studies, involving 1874 gastrointestinal neoplasm patients (1779 in quantitative studies and 95 in qualitative studies). Among the 9 quantitative studies, 1 was a discrete choice experiment. Through analysis, 29 influencing factors were identified, such as perceived benefits, educational level, family caregiver support, economic status, healthcare providers, palatability, adverse reactions, side effects of cancer treatments, and tumor types. These factors were categorized into 9 categories and mapped to the five dimensions of adherence proposed by the World Health Organization. Using a systematic prioritization framework (based on evidence strength, frequency of identification in original studies, and clinical intervenability), three critical determinants emerged as the most impactful: adverse reactions (confirmed by 10 original studies, including 6 high-quality studies), side effects of cancer treatments (supported by 7 original studies, with 5 high-quality studies), and perceived benefits (recognized by 6 original studies, including 5 high-quality studies).
Conclusions
ONS adherence is affected by multiple specific factors, with adverse reactions, cancer treatment side effects, and perceived benefits as critical priorities. Interventions should include symptom management for adverse reactions, supportive care for treatment side effects, standardized nutrition education to enhance perceived benefits, and personalized adjustments for palatability. These recommendations guide targeted clinical interventions and future research on improving ONS adherence. |
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| AbstractList | To explore specific determinants influencing oral nutritional supplementation (ONS) adherence in gastrointestinal neoplasm patients.
This PROSPERO-registered (CRD42024611358) systematic review followed PRISMA 2020 guidelines. Databases including PubMed, Web of Science, and CNKI were searched from inception to April 2025. Included studies underwent quality appraisal and integrative analysis using JBI mixed-methods guidelines.
A total of 14 original studies were included, comprising 9 quantitative studies, 2 qualitative studies, and 3 mixed-methods studies, involving 1874 gastrointestinal neoplasm patients (1779 in quantitative studies and 95 in qualitative studies). Among the 9 quantitative studies, 1 was a discrete choice experiment. Through analysis, 29 influencing factors were identified, such as perceived benefits, educational level, family caregiver support, economic status, healthcare providers, palatability, adverse reactions, side effects of cancer treatments, and tumor types. These factors were categorized into 9 categories and mapped to the five dimensions of adherence proposed by the World Health Organization. Using a systematic prioritization framework (based on evidence strength, frequency of identification in original studies, and clinical intervenability), three critical determinants emerged as the most impactful: adverse reactions (confirmed by 10 original studies, including 6 high-quality studies), side effects of cancer treatments (supported by 7 original studies, with 5 high-quality studies), and perceived benefits (recognized by 6 original studies, including 5 high-quality studies).
ONS adherence is affected by multiple specific factors, with adverse reactions, cancer treatment side effects, and perceived benefits as critical priorities. Interventions should include symptom management for adverse reactions, supportive care for treatment side effects, standardized nutrition education to enhance perceived benefits, and personalized adjustments for palatability. These recommendations guide targeted clinical interventions and future research on improving ONS adherence. ObjectiveTo explore specific determinants influencing oral nutritional supplementation (ONS) adherence in gastrointestinal neoplasm patients.MethodsThis PROSPERO-registered (CRD42024611358) systematic review followed PRISMA 2020 guidelines. Databases including PubMed, Web of Science, and CNKI were searched from inception to April 2025. Included studies underwent quality appraisal and integrative analysis using JBI mixed-methods guidelines.ResultsA total of 14 original studies were included, comprising 9 quantitative studies, 2 qualitative studies, and 3 mixed-methods studies, involving 1874 gastrointestinal neoplasm patients (1779 in quantitative studies and 95 in qualitative studies). Among the 9 quantitative studies, 1 was a discrete choice experiment. Through analysis, 29 influencing factors were identified, such as perceived benefits, educational level, family caregiver support, economic status, healthcare providers, palatability, adverse reactions, side effects of cancer treatments, and tumor types. These factors were categorized into 9 categories and mapped to the five dimensions of adherence proposed by the World Health Organization. Using a systematic prioritization framework (based on evidence strength, frequency of identification in original studies, and clinical intervenability), three critical determinants emerged as the most impactful: adverse reactions (confirmed by 10 original studies, including 6 high-quality studies), side effects of cancer treatments (supported by 7 original studies, with 5 high-quality studies), and perceived benefits (recognized by 6 original studies, including 5 high-quality studies).ConclusionsONS adherence is affected by multiple specific factors, with adverse reactions, cancer treatment side effects, and perceived benefits as critical priorities. Interventions should include symptom management for adverse reactions, supportive care for treatment side effects, standardized nutrition education to enhance perceived benefits, and personalized adjustments for palatability. These recommendations guide targeted clinical interventions and future research on improving ONS adherence. Objective To explore specific determinants influencing oral nutritional supplementation (ONS) adherence in gastrointestinal neoplasm patients. Methods This PROSPERO-registered (CRD42024611358) systematic review followed PRISMA 2020 guidelines. Databases including PubMed, Web of Science, and CNKI were searched from inception to April 2025. Included studies underwent quality appraisal and integrative analysis using JBI mixed-methods guidelines. Results A total of 14 original studies were included, comprising 9 quantitative studies, 2 qualitative studies, and 3 mixed-methods studies, involving 1874 gastrointestinal neoplasm patients (1779 in quantitative studies and 95 in qualitative studies). Among the 9 quantitative studies, 1 was a discrete choice experiment. Through analysis, 29 influencing factors were identified, such as perceived benefits, educational level, family caregiver support, economic status, healthcare providers, palatability, adverse reactions, side effects of cancer treatments, and tumor types. These factors were categorized into 9 categories and mapped to the five dimensions of adherence proposed by the World Health Organization. Using a systematic prioritization framework (based on evidence strength, frequency of identification in original studies, and clinical intervenability), three critical determinants emerged as the most impactful: adverse reactions (confirmed by 10 original studies, including 6 high-quality studies), side effects of cancer treatments (supported by 7 original studies, with 5 high-quality studies), and perceived benefits (recognized by 6 original studies, including 5 high-quality studies). Conclusions ONS adherence is affected by multiple specific factors, with adverse reactions, cancer treatment side effects, and perceived benefits as critical priorities. Interventions should include symptom management for adverse reactions, supportive care for treatment side effects, standardized nutrition education to enhance perceived benefits, and personalized adjustments for palatability. These recommendations guide targeted clinical interventions and future research on improving ONS adherence. To explore specific determinants influencing oral nutritional supplementation (ONS) adherence in gastrointestinal neoplasm patients.OBJECTIVETo explore specific determinants influencing oral nutritional supplementation (ONS) adherence in gastrointestinal neoplasm patients.This PROSPERO-registered (CRD42024611358) systematic review followed PRISMA 2020 guidelines. Databases including PubMed, Web of Science, and CNKI were searched from inception to April 2025. Included studies underwent quality appraisal and integrative analysis using JBI mixed-methods guidelines.METHODSThis PROSPERO-registered (CRD42024611358) systematic review followed PRISMA 2020 guidelines. Databases including PubMed, Web of Science, and CNKI were searched from inception to April 2025. Included studies underwent quality appraisal and integrative analysis using JBI mixed-methods guidelines.A total of 14 original studies were included, comprising 9 quantitative studies, 2 qualitative studies, and 3 mixed-methods studies, involving 1874 gastrointestinal neoplasm patients (1779 in quantitative studies and 95 in qualitative studies). Among the 9 quantitative studies, 1 was a discrete choice experiment. Through analysis, 29 influencing factors were identified, such as perceived benefits, educational level, family caregiver support, economic status, healthcare providers, palatability, adverse reactions, side effects of cancer treatments, and tumor types. These factors were categorized into 9 categories and mapped to the five dimensions of adherence proposed by the World Health Organization. Using a systematic prioritization framework (based on evidence strength, frequency of identification in original studies, and clinical intervenability), three critical determinants emerged as the most impactful: adverse reactions (confirmed by 10 original studies, including 6 high-quality studies), side effects of cancer treatments (supported by 7 original studies, with 5 high-quality studies), and perceived benefits (recognized by 6 original studies, including 5 high-quality studies).RESULTSA total of 14 original studies were included, comprising 9 quantitative studies, 2 qualitative studies, and 3 mixed-methods studies, involving 1874 gastrointestinal neoplasm patients (1779 in quantitative studies and 95 in qualitative studies). Among the 9 quantitative studies, 1 was a discrete choice experiment. Through analysis, 29 influencing factors were identified, such as perceived benefits, educational level, family caregiver support, economic status, healthcare providers, palatability, adverse reactions, side effects of cancer treatments, and tumor types. These factors were categorized into 9 categories and mapped to the five dimensions of adherence proposed by the World Health Organization. Using a systematic prioritization framework (based on evidence strength, frequency of identification in original studies, and clinical intervenability), three critical determinants emerged as the most impactful: adverse reactions (confirmed by 10 original studies, including 6 high-quality studies), side effects of cancer treatments (supported by 7 original studies, with 5 high-quality studies), and perceived benefits (recognized by 6 original studies, including 5 high-quality studies).ONS adherence is affected by multiple specific factors, with adverse reactions, cancer treatment side effects, and perceived benefits as critical priorities. Interventions should include symptom management for adverse reactions, supportive care for treatment side effects, standardized nutrition education to enhance perceived benefits, and personalized adjustments for palatability. These recommendations guide targeted clinical interventions and future research on improving ONS adherence.CONCLUSIONSONS adherence is affected by multiple specific factors, with adverse reactions, cancer treatment side effects, and perceived benefits as critical priorities. Interventions should include symptom management for adverse reactions, supportive care for treatment side effects, standardized nutrition education to enhance perceived benefits, and personalized adjustments for palatability. These recommendations guide targeted clinical interventions and future research on improving ONS adherence. |
| ArticleNumber | 789 |
| Author | Zheng, Nengtong Yu, Doudou Fan, Siyue Chen, Lijuan Chai, Wenting Lin, Yanni Yang, Liping |
| Author_xml | – sequence: 1 givenname: Yanni surname: Lin fullname: Lin, Yanni organization: Nursing College, Fujian University of Traditional Chinese Medicine – sequence: 2 givenname: Siyue surname: Fan fullname: Fan, Siyue organization: School of Nursing, Ningxia Medical University – sequence: 3 givenname: Wenting surname: Chai fullname: Chai, Wenting organization: Nursing College, Fujian University of Traditional Chinese Medicine – sequence: 4 givenname: Nengtong surname: Zheng fullname: Zheng, Nengtong organization: Nursing College, Fujian University of Traditional Chinese Medicine – sequence: 5 givenname: Doudou surname: Yu fullname: Yu, Doudou organization: Nursing College, Fujian University of Traditional Chinese Medicine – sequence: 6 givenname: Liping surname: Yang fullname: Yang, Liping organization: Nursing College, Fujian University of Traditional Chinese Medicine – sequence: 7 givenname: Lijuan surname: Chen fullname: Chen, Lijuan email: xmetchenlijuan@163.com organization: Nursing College, Fujian University of Traditional Chinese Medicine, Nursing Department, Zhongshan Hospital, Xiamen University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40815420$$D View this record in MEDLINE/PubMed |
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| Keywords | Oral nutritional supplementation Mixed method systematic review Treatment adherence and compliance Influencing factors Gastrointestinal neoplasms |
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To explore specific determinants influencing oral nutritional supplementation (ONS) adherence in gastrointestinal neoplasm patients.
Methods
This... To explore specific determinants influencing oral nutritional supplementation (ONS) adherence in gastrointestinal neoplasm patients. This PROSPERO-registered... ObjectiveTo explore specific determinants influencing oral nutritional supplementation (ONS) adherence in gastrointestinal neoplasm patients.MethodsThis... To explore specific determinants influencing oral nutritional supplementation (ONS) adherence in gastrointestinal neoplasm patients.OBJECTIVETo explore... |
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| SubjectTerms | Administration, Oral Cancer therapies Chemotherapy Clinical outcomes Dietary Supplements Enteral nutrition Gastrointestinal Neoplasms - therapy Humans Malnutrition Medical prognosis Medical research Medicine Medicine & Public Health Metabolism Mixed methods research Mortality Nursing Nursing Research Nutrition Oncology Pain Medicine Patient Compliance - statistics & numerical data Patients Qualitative research Quality of life Rehabilitation Medicine Research methodology Researchers Review Subject heading schemes Systematic review Tumors |
| Title | Factors influencing adherence to oral nutritional supplementation in patients with gastrointestinal neoplasms: a mixed methods systematic review |
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