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How to incorporate geriatric assessment in clinical decision-making for older patients with cancer. An implementation study.
- Source :
-
Journal of geriatric oncology [J Geriatr Oncol] 2019 Nov; Vol. 10 (6), pp. 951-959. Date of Electronic Publication: 2019 Apr 26. - Publication Year :
- 2019
-
Abstract
- Introduction: With the accumulating evidence on the added value on prediction of outcomes of geriatric assessment (GA) in older patients with cancer, the question shifts from whether performing a GA is useful, to how to implement this into standard practice in a feasible and effective way. The effect of implementing GA, and assessment of patient preferences on treatment recommendations by an onco-geriatric multidisciplinary team (MDT), was compared to the recommendation previously made by the tumor board (care as usual).<br />Methods: Patients aged 70 years and older with a solid malignancy who were referred to a tertiary care center for diagnosis and treatment recommendations, as provided by a tumor board, were included. The intervention consisted of: a nurse-led GA and assessment of patient preferences prior to the start of oncological treatment, discussing this in an onco-geriatric MDT, and weighing all this information in a structured, stepwise manner. Treatment recommendations formulated by this onco-geriatric MDT were compared to the treatment recommendations by the tumor board.<br />Results: Of 236 eligible patients, 197 were included. For 27%, treatment recommendations from the onco-geriatric MDT differed from the recommendations formulated by the tumor board. These modifications were mostly towards less intensive curative or palliative treatment. Thirteen percent of patients were subsequently referred to a geriatrician in order to reach a treatment recommendation.<br />Discussion: Implementing an onco-geriatric care trajectory, using GA and assessment of patient preferences, resulted in an adjustment of treatment recommendations for a quarter of patients. Thirteen percent needed subsequent referral to a geriatrician.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1879-4076
- Volume :
- 10
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of geriatric oncology
- Publication Type :
- Academic Journal
- Accession number :
- 31031193
- Full Text :
- https://doi.org/10.1016/j.jgo.2019.04.006