Multidisciplinary Supportive Cancer Care: Nutritional and Exercise Counseling Pathways Using Electronic Patient-Reported Outcomes, Patient Guides, and Tumor Board Decisions

PURPOSE: Evidence supports nutritional and exercise interventions in oncology, yet their integration into routine care remains inconsistent. We evaluated a single-center, electronic patient-reported outcome‑based supportive care pathway and examined factors associated with completion of nutritional and exercise counseling. METHODS: We conducted a retrospective analysis of routinely collected clinical and electronic patient-reported outcome data from outpatients at the National Center for Tumor Diseases Dresden between January and November 2024. Patients completing at least 1 nutritional or exercise-related screening were included (first screening per patient). Pathway performance was assessed from screening above predefined thresholds to counseling offer, acceptance, and completion within 3 months. Associations between pathway characteristics, including supportive care tumor board (STB) involvement, and counseling completion were analyzed using multivariable logistic regression. RESULTS: A total of 1,256 patients were analyzed (mean age, 64.5 years; 57.5% male). Nutritional screening identified risk in 664 of 1,068 patients (62.2%), and exercise screening identified need in 1,046 of 1,240 patients (84.4%). Among patients above the threshold, no counseling offer was made for 27.6% (nutrition) and 52.9% (exercise). Of those offered counseling, most declined (82.8% nutrition; 86.2% exercise). Counseling was completed by 71 patients for nutrition (13.6% of those offered) and 55 for exercise (11.2% of those offered). STB involvement was independently associated with higher completion of exercise (odds ratio [OR], 2.8; 95% CI, 1.5 to 5.4) and nutritional counseling (OR, 2.3; 95% CI, 1.2 to 4.4). CONCLUSION: In routine outpatient oncology care, high screening-defined supportive care needs did not translate into proportional utilization of nutritional and exercise counseling. Multidisciplinary tumor board involvement was associated with higher counseling completion and may support implementation of structured supportive care pathways.