Pancreatic enzyme replacement therapy in patients with pancreatic cancer: A national prospective study

ObjectiveUK national guidelines recommend pancreatic enzyme replacement therapy (PERT) in cancer. Over 80% of cancers are unresectable and managed non-surgical units. The aim was to assess variation PERT prescribing, determine factors associated with its use identify potential actions improve prescription rates.DesignRICOCHET a prospective audit malignant pancreatic, peri-ampullary lesions or biliary obstruction between April August 2018. This analysis focuses on cancer patients is reported STROBE guidelines. Multivariable regression undertaken prescribing.ResultsRates prescribing varied among the 1350 included. 74.4% potentially resectable disease were prescribed compared 45.3% disease.PERT across surgical hospitals but high rates did not disseminate out respective referring network. appeared be related treatment for patient amount clinician contact has. positively dietitian referral (p = 0.001) management at hepaticopancreaticobiliary 0.049) unit 0.009). Prescription also had negative association Charlson comorbidity score 5–7 0.045) >7 0.010) positive clinical nurse specialist review 0.028).ConclusionDespite guidance, wide under-treatment exists. Given that most have treated hospitals, where lowest, strategies best practice overcome barriers urgently required.