How to incorporate geriatric assessment in clinical decision-making for older patients with cancer. An implementation study

Festen, S., Kok, M., Hopstaken, J. S., van der Wal-Huisman, H., van der Leest, A., Reyners, A. K. L., de Bock, G. H., de Graeff, P. & van Leeuwen, B. L., Nov-2019, In : Journal of Geriatric Oncology. 10, 6, p. 951-959 8 p.

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  • How to incorporate geriatric assessment in clinical decision-making for older patients with cancer. An implementation study

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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).

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.

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.

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.

Original languageEnglish
Pages (from-to)951-959
Number of pages8
JournalJournal of Geriatric Oncology
Issue number6
Publication statusPublished - Nov-2019

ID: 82483034