Bridging the Nutrition Care Gap in Oncology: The role of specialty pharmacy and registered dietitians
Nutrition plays a critical role in oncology care, yet up to 80% of cancer patients experience malnutrition at some point during their journey. Malnutrition can lead to worsened outcomes, reduced treatment tolerance, and diminished quality of life. Despite the American College of Surgeons Commission on Cancer requiring nutrition services for accreditation, many patients lack access to a registered dietitian (RD) due to various barriers, including awareness, cost, and referral pathways.
Accredo® Specialty Pharmacy is uniquely positioned to help bridge this gap by incorporating RDs into oncology care teams. A recent Accredo study, presented at the 2025 Annual Oncology Nursing Society (ONS) Congress, highlights the importance of RD referrals in specialty pharmacy settings as a pathway to increase patient access to nutrition care and promote health equity.
Understanding the Barriers to Nutrition Care
Findings from the study demonstrate that 61% of oncology patients who spoke to a dietitian at Accredo and participated in the survey had not received prior care from an RD since their cancer diagnosis.
Among reasons cited:
- Forty-three patients reported that they did not receive a referral to a dietitian.
- Twenty-five patients shared they did not have previous nutrition concerns.
- One patient declined a referral to a dietitian when it was offered.
- One patient cited cost as the primary barrier to receiving nutrition services.
- Thirty-nine patients did not specify a reason.
This data underscores that the referral pathways are the most common reason patients do not receive essential nutrition support.
Disparity in health care access is a social determinant of health (SDoH), under the broader heading of health coverage and access, in addition to other factors such as:
- Economic status
- Education levels
- Language barriers
- Health coverage
- Food security
Patients identified as having high or extremely high SDoH risk according to the proprietary Evernorth Social Determinants of Health Index were more likely to report that they were not previously referred to a dietitian. The referral for consultation with an SP RD serves an unmet need for patients who live in communities with the highest risk of health disparities.
How Accredo Supports Oncology Nutrition
A specialty pharmacy model, like Accredo’s, offers a unique solution to address nutrition gaps. Specialty pharmacies not only dispense oncology-specific medications but also provide clinical support that extends beyond traditional specialty pharmacy care. By integrating RDs into their interdisciplinary teams, specialty pharmacies can enhance access to nutrition care. Oncology nurses and pharmacists within the SP setting are trained to identify potential nutritional concerns early and refer patients to an RD proactively, ensuring timely intervention.
An oncology-certified RD plays a critical role in improving access to essential nutrition care, particularly for patients who are at a substantial risk of health disparities. In many cases, patients do not actively seek nutrition support simply because they are unaware of its importance or how to access it. Accredo’s nutrition referrals are streamlined, making it easier for patients to connect with an RD without barriers.
Accredo also provides oncology patients with access to nutrition articles written by our board-certified oncology dietitian on topics ranging from how to manage side effects to how to read nutrition labels. This platform, TherapEase Cuisine, is available to patients 24/7 within the Accredo patient portal and compliments the clinical expertise of the care team by helping patients make informed food choices that align with their treatment journey.
This approach is particularly valuable for patients in high-risk communities, where social determinants of health (SDoH)—such as economic instability or food insecurity—can negatively impact nutritional well-being. By embedding RDs within the workflow, Accredo is helping to bridge the gap in oncology nutrition and ensure more equitable access to care.
Key Takeaways from the Oncology Nutrition Research
- Clinical Training: Oncology nurses and pharmacists are trained to identify nutritional needs early and act as an extension to the prescribing physician in proactively referring patients to an RD.
- Interdisciplinary Collaboration: A team-based approach between nurses, pharmacists, and dietitians ensures patients have timely access to nutrition interventions.
- RD Referrals Address Disparities: The referral for consultation with an SP RD serves an unmet need for patients who live in communities with the highest risk of health disparities.
Moving Toward Comprehensive Cancer Care
The integration of Registered Dietitians within specialty pharmacy settings represents a critical advancement in oncology care. By proactively identifying at-risk patients and facilitating nutrition referrals, Accredo is closing an important gap in cancer care.
As oncology nurses continue to champion holistic, patient-centered care, collaboration with RDs and pharmacists will remain essential in enhancing quality of life and treatment outcomes for those battling cancer.
Want to learn more? Download the full Accredo Oncology Nutrition Care Poster to explore the data, insights, and key takeaways that can help improve oncology nutrition care. https://www.accredo.com/access-to-registered-dietitian.pdf
