Home parenteral nutrition in patients receiving palliative care: a curriculum-based review

Research output: Contribution to journalReview articlepeer-review


  • Jane Fletcher
  • Diane Woodham
  • Merceline Dera
  • Sheldon C Cooper

Colleges, School and Institutes


Difficulty with maintaining nutritional intake is common in patients with cancer. European guidance suggests that wherever possible nutritional support should first be provided by the oral or enteral route. Where this is not possible, for example, in malignant small bowel obstruction, parenteral nutrition (PN) may be considered. In palliative care, it is generally accepted that the significant risks and burdens of PN outweigh the potential benefits in patients with an expected survival <2 months. Determining prognosis is crucial when helping patients to make decisions regarding appropriate care pathways; however, this remains challenging. An overview of clinical issues and prognostic indicators related to selecting patients appropriately for palliative PN is given to cover the relevant advanced competencies of the 2010 Gastroenterology Curriculum. The organisation of Home Parenteral Nutrition (HPN) services in England is described including the associated risks and burdens of HPN in the palliative patient.

Bibliographic note

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.


Original languageEnglish
Pages (from-to)421-426
Number of pages6
JournalFrontline Gastroenterology
Issue number4
Early online date17 Dec 2018
Publication statusPublished - Oct 2019


  • cancer, clinical decision making, gastric cancer, parenteral nutrition, quality of life

ASJC Scopus subject areas