Embedded Geriatric Consultations May Improve Care Planning for Elderly With Hematologic Malignancies

Researchers found that embedded geriatric consultation may not affect 1-year survival in frail or prefrail elderly patients with blood cancers, but it may influence care planning. These study results were presented at the 61st American Society of Hematology (ASH) Annual Meeting & Exposition, held in Orlando, Florida.

In this study, outcomes of consultations with embedded geriatricians were evaluated in patients aged 75 years and older who had hematologic malignancies. Patients who were initially assessed to be frail or prefrail were randomized to receive either usual care (n=100) or care that included geriatric consultations (n=60). A total of 65 oncologists and physician extenders were also surveyed about the perceived usefulness of geriatric consultations.

Patients were a median of 80.4 years old. At least one consultation was completed by 80% (n=48) of the patients assigned to receive geriatric consultations. Three patients who did not complete a consultation had died before the first planned appointment.

Survival was not significantly different between groups in both intent-to-treat and as-treated analyses (for as-treated analysis: hazard ratio, 0.87 [95% CI, 0.49-1.55]).

Documented communication about goals of care was significantly more common for patients who participated in at least 1 geriatric consultation (odds ratio, 3.07 [95% CI, 1.06-8.82]; P =.04) than for patients who were given usual care.

Survey results were completed by 57% of the providers. Responses suggested that geriatric consultation was considered useful for care-related needs, such as linking patients to resources and treating nononcologic morbidities.

The investigators concluded that geriatric consultation did not show an effect on 1-year survival, but it did likely play a role in end-of-life care planning.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original abstract for a full list of disclosures.

Reference

Abel GA, Uno H, Tanasijevic AM, et al. Feasibility and impact of embedded geriatric consultation for frail older adults with blood cancer: a randomized controlled trial. Oral presentation at: 61st ASH Annual Meeting & Exposition; December 7-10, 2019; Orlando, FL. Abstract 67.