A study investigating whether more regular, individualised dietary counselling with patients and their caregivers can improve quality of life in people with cancer and those looking after them.

In this two arm randomised controlled trial (RCT), subjects who are randomised to the intervention group will receive an intensive nutrition intervention by an Accredited Practising Dietitian who is highly skilled in cancer care and independent of both the research team and usual care for medical oncology cancer care dietetic services. The intervention provides 2-2.5 hours of dietitian direct contact time over a 4-5-week period, including regular, frequent follow up to monitor, re-enforce and adjust goals, with a focus on including family/carers in the process where applicable. The intervention for this trial is refined based on findings from prior feasibility intervention study. The focus of this intervention is to improve symptoms and quality of life and psychosocial outcomes in patients and caregivers through nutritional counselling, rather than solely achieving sufficient energy/protein intake as per traditional dietary interventions. The intervention will last for 4 weeks and includes the following components: WEEK 1, DAY 1 - Face-to-face counselling over 1-1.5 hrs, to: 1. Assess patient’s nutrition status, nutrition impact symptoms and diet history including any dietary beliefs; 2. Negotiate nutritional goals with patient and caregivers; 3. Answer any nutrition-related questions from patient and family if any; 4. Provide patient and family-centred nutrition counselling supplemented with relevant nutrition education materials; 5. Liaise with multidisciplinary team (MDT) for management of nutrition impact symptoms as required; and 6. Make an appointment for telehealth-based reinforcement counselling. WEEK 3, DAY 1 - Reinforcement counselling face-to-face or via videoconference (telehealth) over 30 minutes, to: 1. Assess patient’s nutrition status, nutrition impact symptoms and diet history; 2. Identify barriers/facilitators to goal achievement and adjust goal if necessary; 3. Provide patient and family-centred nutrition counselling; and 4. Make an appointment for telehealth follow-up. WEEK 5, DAY 1 - Follow-up face-to-face or via videoconference (telehealth) over 30 minutes, to: 1. Assess patient’s nutrition status, nutrition impact symptoms and diet history; 2. Discuss nutritional goal achievement; 3. Identify barriers/facilitator to inform future goal setting and adjust goal if necessary; 4. Provide further patient and family-centred nutrition counselling as required; and 5. Discuss if patient would like ongoing care and refer into usual care as required.