Malnutrition risk at solid tumor diagnosis: the malnutrition screening tool in a large US cancer institute.

BACKGROUND: In cancer, malnutrition is common and negatively impacts tolerance and outcomes of anti-tumor therapies. The aim of this study was to evaluate the prevalence of malnutrition risk and compare the clinicodemographic features between those with high malnutrition screening tool (MST) scores (i.e., ≥ 2 of 5 = high risk for malnutrition, H-MST) to low scores (L-MST). METHODS: A cohort of 3585 patients (May 2017 through December 2018), who completed the MST at least once at the time of diagnosis of any stage solid tumor, were analyzed. Logistic regression tested for associations between clinicodemographic factors, symptom scores, and H-MST prevalence. RESULTS: The median age was 64 years (25-75 IQR, 55-72), with 62% females and 81% White. Most common tumor primary sites were breast (28%), gastrointestinal (GI) (21%), and thoracic (13%). Most had non-metastatic disease (80%). H-MST was found in 28%-most commonly in upper (58%) and lower GI (42%), and thoracic (42%) tumors. L-MST was most common in breast (90%). Multivariable regression confirmed that Black race (OR 1.9, 95% CI 1.5-2.4, p = < 0.001), cancer primary site (OR 1.6-5.7, p = < 0.001), stage IV disease (OR 1.8, 95% CI 1.4-2.2, p = < 0.001), low BMI (OR 4.2, 95% CI 2.5-6.9 p = < 0.001), and higher symptom scores were all independently associated with H-MST. CONCLUSIONS: Twenty-eight percent of solid tumor oncology patients at diagnosis were at high risk of malnutrition. Patients with breast cancer rarely had malnutrition risk at diagnosis. Significant variation was found in malnutrition risk by cancer site, stage, race, and presence of depression, distress, fatigue, and trouble eating/swallowing.

Implementation of a pharmacy residency resiliency program for PGY1 and PGY2 residents: Program structure and resident perceptions.

PURPOSE: To describe the implementation of a pharmacy residency resiliency program (PRRP) for postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residents, including program structure, strengths and weaknesses/limitations, resident perceptions as captured by a postprogram survey, generalizability to other institutions, and opportunities for future directions. SUMMARY: Pharmacy residents face significant pressure, workload, and stressors that put them at risk for burnout and depression. While resiliency has been a major area of focus to help combat these risks for healthcare professionals, little has been published regarding formal, structured resiliency training in pharmacy, especially in pharmacy residency programs. American Society of Health-System Pharmacists (ASHP) residency standards recommend that programs consider education related to burnout prevention and that mitigation strategies be provided to residents and other pharmacy personnel, but no formal pharmacy-specific programs or strategies have been established. We implemented a 12-month PRRP for PGY1 and PGY2 pharmacy residents and conducted a postprogram survey to assess resident perceptions and to identify areas for growth. CONCLUSION: Implementation of a PRRP was feasible and could be replicated at other institutions. Residents in our program reported a high level of satisfaction, skills gained, and positive attributes of the addition of the PRRP. Some notable factors contributing to success included the program's longitudinal nature, use of a nonpharmacy facilitator, and impactful content from an established resiliency skills curriculum.