Interprofessional selection and integration of multimodal cachexia interventions into cancer care: an interpretive description study

Cancer cachexia negatively impacts health, quality of life and prognosis. Although clinical guidelines and evidence support multimodal management to improve patient outcomes, challenges remain in translating recommendations into clinical practice. This study describes how an interprofessional (IP) team selects and integrates multimodal interventions for cancer cachexia, offering insight into how multimodal care can be implemented alongside cancer care.

Interpretive description guided this single-site study conducted in a specialized cancer cachexia clinic within a cancer center. Over 18 months, 188 patients, 27 family caregivers and 7 health care professionals (HCPs) were observed during clinical events, 10 HCPs were interviewed and 368 clinical documents were reviewed. Analysis occurred within and across data sources using descriptive and focused coding with the constant comparative method. Analytic memos and peer-debriefing aided analysis.

Three analytic categories described how multimodal cachexia care was delivered: tailoring multimodal interventions, determining cachexia rehabilitation potential and integrating interventions into cancer care. The IP team tailored medical, nutritional, symptom-management and functional interventions by considering type, timing, sequencing and prioritization over time. Cachexia rehabilitation potential was routinely assessed and informed individualized goals and intervention selection. Clinical factors, patient preferences and potential barriers shaped intervention feasibility. Multimodal cachexia interventions were integrated and adapted alongside cancer care as patients' conditions and needs evolved.

Multimodal cachexia care involved an iterative process of assessing rehabilitation potential, individualizing and prioritizing interventions and adapting them within cancer care. Findings identify practical considerations that may help clinicians operationalize multimodal cancer cachexia management in other clinical settings.