The Knowledge, Attitude, and Practice Score on Oral Nutrition Supplementation Is Inversely Associated with Malnutrition Risk of Tumor Patients During the Peri-Radiotherapy Period: A Multicenter Cross-Sectional Study

Why It Matters

Improving patients' understanding and use of oral nutrition supplements can substantially reduce malnutrition, a major driver of treatment complications and healthcare costs in oncology.

Key Takeaways

• 70% of surveyed cancer patients faced malnutrition risk during radiotherapy.
• Higher KAP scores cut malnutrition odds by more than half (OR 0.48).
• Education level strongly predicts patients’ knowledge, attitude, and practice toward ONS.
• Only 15% of patients actually used oral nutrition supplements despite willingness.

Pulse Analysis

Malnutrition remains a pervasive challenge in oncology, affecting up to three‑quarters of patients receiving radiotherapy. The physiological stress of treatment, combined with tumor‑related metabolic changes, accelerates weight loss and muscle wasting, which in turn compromise immune function and increase toxicity. While clinical guidelines endorse oral nutrition supplements (ONS) as a first‑line intervention, real‑world adoption hinges on patients’ awareness and attitudes. This study’s large sample across 25 hospitals provides robust evidence that knowledge gaps, especially among less‑educated patients, translate into poorer nutritional outcomes.

The data reveal a clear dose‑response relationship: patients in the highest quartile of KAP scores experienced a 52% reduction in malnutrition risk compared with those in the lowest quartile. Notably, education level was the most powerful determinant of KAP, underscoring the role of health literacy in nutritional self‑management. Despite 85% of respondents expressing willingness to take ONS, only 15% actually did so, highlighting a disconnect between intention and practice that may stem from limited access, insufficient counseling, or cultural preferences for traditional remedies.

For healthcare systems, these findings point to a cost‑effective lever—structured nutrition education integrated into routine oncology visits. By training clinicians to deliver concise, evidence‑based guidance and by leveraging hospital pharmacies to streamline ONS provision, institutions can close the knowledge‑practice gap. Such interventions promise not only to improve patient quality of life but also to reduce hospitalization costs associated with treatment interruptions and infection, aligning clinical outcomes with fiscal sustainability.