Assessment improves cancer care of older adults

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When physicians fully appreciate the concerns older adults with cancer have, such as function and forgetfulness, it elevates patient care and satisfaction, according to a new study.

Researchers believe the study is the first to assess in a randomized clinical trial whether a tool known as geriatric assessment (GA) can meaningfully influence cancer care for vulnerable older people.

Many oncologists in community practices are not aware of, or don’t ask patients who are 70 or older, about living conditions, functional ability, cognition, and family support, for example.

But these kinds of impairments link to chemotherapy toxicity, an inability to complete treatment, and an overall decline in health or risk of early death, says Supriya Mohile, professor of hematology/oncology at the University of Rochester Medical Center and corresponding author of the paper in JAMA Oncology.

A geriatric assessment can personalize care and prompt better conversations among physicians, patients, and their families, the study shows.

“We’ve shown that we can modify the behavior of oncologists if they have the right tools and guidance,” says Mohile, who also co-leads the Cancer Survivorship and Supportive Care research program at Wilmot Cancer Center.

“And when oncologists are better informed about the special needs of their older adult patients, everyone’s experience is much improved.”

Health professionals should consider a GA summary standard care for older adults with cancer, and use appropriate interventions based on the report as needed, researchers say.

A case might look like this: Jane Doe recently fell at home, which a geriatric assessment revealed. Evidence shows that falls increase the risk of chemotherapy side effects, and therefore the physician talks to Jane and Jane’s primary caregiver about those risks and recommends physical therapy to prevent additional falls.

The study involved 541 older people with advanced cancer receiving treatment at 31 oncology clinics across the US, through the university’s National Cancer Institute Community Oncology Research Program.

The oncology practices either received a tailored GA assessment and summary with recommendations for the patient, or the usual alerts related to depression or cognitive impairment. Then, researchers measured patient and caregiver satisfaction with questionnaires and through audio recordings of physician visits.

The Patient-Center Outcomes Research Institute, the National cancer Institute, and the National Institute of Aging funded the work.

Source: University of Rochester