Using a geriatric oncology assessment to link with services (GOAL)

• Published in: Journal of geriatric oncology Vol. 10; no. 1; pp. 164 - 168
• Main Authors: Zullig, Leah L., Kimmick, Gretchen, Smith, Valerie, Little, Katie, Bosworth, Hayden B., Gonzales, Sarah, Oakes, Megan M., Shelby, Rebecca A., Owen, Lynda, Altomare, Ivy P.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.01.2019
• Subjects: Aged; Cancer; Clinical Decision-Making - methods; Community-based; Female; Geriatric assessment; Geriatric Assessment - methods; Humans; Male; Medical Oncology - methods; Neoplasms - complications; Neoplasms - diagnosis; Neoplasms - therapy; Older patients; Referral; Referral and Consultation; Older patients; Geriatric assessment; Referral; Community-based; Cancer
• ISSN: 1879-4068; 1879-4076; 1879-4076
• DOI: 10.1016/j.jgo.2018.06.004

Geriatric screening tools assess functional limitations and inform clinical decision-making for older adults with cancer. Our objective was to evaluate the feasibility and effectiveness of a screener in community-based oncology clinics. Eligible patients were from two rural, underserved community-based cancer clinics; within 12 months of a cancer diagnosis (breast, lung, colorectal, pancreas, esophageal); aged ≥60 years; and not exclusively pursuing palliative care. We used a previously validated tool that was embedded in the electronic health record (EHR). Patient-reported responses identified memory impairment, depressive symptoms, deficits in activities of daily living, poor nutrition, and polypharmacy. At the discretion of the oncologist, responses prompted service referrals. From the EHR, we extracted information about referrals and completion of planned therapy. We present descriptive statistics. Enrolled patients (n = 44) had a mean age of 71.5 years (SD = 6.9). Most were non-white (61%), women (66%), with government-sponsored health insurance (80%). The most commonly identified geriatric syndromes: polypharmacy (89%), reduced quality of life (39%), and poor nutrition (39%). The screener triggered a referral in 98% of patients. Generated referrals were for depressive symptoms (52% needed, 39% received), nutrition (43% needed, 37% received), and polypharmacy (89% needed, 26% received). Patients were referred to social work (56%), nutrition (44%), and pharmacy (25%). Many patients completed planned radiation therapy (100%), surgery (70%), and chemotherapy (60%). Use of an EHR-embedded brief geriatric oncology assessment in rural oncology clinics identified geriatric syndromes that would benefit from provision of services in nearly all enrolled patients. ClinicalTrials.gov Identifier: NCT02906592.