Geriatric Assessment in Elderly Cancer Patients Receiving Chemotherapy in Ain Shams University Hospital: An Implementation Study

Document Type : Original Article

Authors

1 1Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine Ain Shams University, Egypt

2 Geriatric Medicine and Gerontology Department, Faculty of Medicine Ain Shams University, Egypt

Abstract

Background: In contrast to chronological age, the comprehensive geriatric assessment (CGA) was created as a multidisciplinary framework to measure the influence of age-associated physiological parameters that may affect health and disease in older persons. Aim and objectives: The purpose of the study was to evaluate the benefits of using geriatric assessments (GA) for elderly cancer patients receiving chemotherapy in Ain Shams University Hospital.
Subjects and methods: This prospective cohort study was conducted in the Department of clinical oncology and Nuclear Medicine, Ain Shams University Hospital from October 1, 2019, to March 31, 2020. The patients who were referred by the specialized oncology clinics with certain decisions for chemotherapy were assessed using the G8 questionnaire by the oncology residents, and based on the G8 score, the patient either received the scheduled regimen and dose (if the G8 score >14) or was referred to the geriatric clinic for CGA (if the G8 score ≤ 14). Following CGA, a discussion was held between the clinical oncologist and the geriatrician to see whether the treatment choice had changed. In this study, we compared the proportion of decisions that changed before and after CGA. The current study also identified the difficulties encountered in setting up the onco-geriatric clinic and provided strategies to address the majority of these difficulties.
Results: This study was conducted on 117 Elderly cancer patients (aged 60 years and older), referred for chemotherapy, for whom a G8 score questionnaire was done, accordingly 86 (73.5%) patients were candidates for CGA - as their G8 score was ≤ 14 - after a treatment decision was given by the conventional oncology clinics. Of those candidate patients, 38 individuals missed CGA due to different reasons.
In 79.1% (n = 38) of patients, the onco-geriatric clinic supported the treatment recommendation made by the conventional oncology clinics. However, in 20.8% (n = 10) of the patients, the treatment proposal was modified according to the recommendations of the onco-geriatric clinic.
Conclusion: Implementation of CGA as an integrated part of the decision-making in the oncology clinics gave better information about the physiological state of elderly cancer patients and led to optimum decision-making.

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