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‘I have to drink it to survive’: patients’ experiences and barriers to adherence to oral nutritional supplements in cancer care: a qualitative study
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DOI：10.1007/s00520-026-11060-8.png)
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Abstract
En 中文
Although oral nutritional supplements (ONSs) are widely prescribed to combat cancer-related malnutrition and enhance treatment outcomes, patient adherence is often inadequate. This study aims to examine patient-reported barriers and facilitators to ONS use in cancer care, with the goal of supporting healthcare professionals in developing patients’ nutritional strategies. A qualitative study was conducted. Between November 2023 and August 2024, semistructured interviews were conducted with 20 purposively selected cancer patients until data saturation was achieved. The health belief model (HBM) guided data collection and interpretation. Adherence patterns were derived from participants’ self-reports. Data were analyzed using a two-stage approach: inductive, experience-oriented thematic analysis followed by theory-informed mapping of finalized themes onto HBM constructs. Sixteen themes were identified reflecting perceptions of ONS use. Participants perceived their adherence as suboptimal and described inconsistent consumption of prescribed supplements. While participants acknowledged that poor nutritional intake could compromise recovery, barriers were prominent. These included unpleasant taste and odor, gastrointestinal side effects, sensory fatigue from limited flavors, misconceptions such as “sugar feeds cancer,” and inadequate professional guidance. Barriers were shaped by individual health beliefs, emotional responses, and contextual support systems. Facilitators included motivation for recovery, family support, and supportive interactions with healthcare professionals. Adherence to ONS among cancer patients is influenced by multifaceted factors extending beyond medical prescription. Addressing misconceptions, improving palatability and product variety, and strengthening professional and psychosocial support may enhance adherence. Tailored interventions guided by patient beliefs and experiences are essential to optimize nutritional outcomes during cancer treatment.
Keywords:
Adherence
Cancer
Qualitative research
Patient experiences
Oral nutritional supplements
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