Physicians Found to Seek Geriatric Assessments of Older Patients With Cancer by Nurses Trained in Oncology and Geriatrics

A recent analysis evaluated the use of geriatric assessments by skilled nurses in treatment of patients with cancer, with results reported in the Journal of Geriatric Oncology.¹

According to the study investigators, patients aged 70 years or older constitute approximately half of all cases of cancer.

The researchers explored the utility of geriatric assessments conducted by nurses through the use of the Mobile Geriatric Oncology Unit associated with the University Hospital of Toulouse in Toulouse, France. In this study, 3 nurses with both oncologic and geriatric training could visit patients (N=183 evaluated) at a variety of facilities upon physicians’ requests.

In addition to obtaining information on a variety of patient characteristics, the nurses gave patients initial comprehensive geriatric assessments, including questionnaires to estimate levels of activity, cognitive status, and other aspects of function.

Evaluations in this study were the first geriatric evaluations experienced by 96% of the patients. Patients who completed questionnaires showed mean scores of 4.7 for activities of daily living (ADLs; n=162 evaluated), 5.1 for instrumental ADLs (n=141), 10.0 on the G8 questionnaire (n=180), 21.6 for the Mini Nutritional Assessment (n=122), and 21.4 for the Mini-Mental State Examination (n=17). Among 101 patients analyzed, 30.0% had lost weight in the 3 months prior to the assessment, with a mean of 6.7 kg lost.

Treatments received by 62% of the patients in this study were in agreement with nurses’ suggestions to oncologists. Geriatric assessments, per patient, required an average of 60.0 minutes. Individual physicians (n=76) sought the aid of the nurses for an average of 2.4 patients per year. Physicians were noted to often enlist the nurses’ assistance with assessing patients who showed potential for a loss of autonomy.

“This first real-life approach to the potential role that nurses can play in improving access to geriatric care beyond dedicated hospital units is encouraging,” wrote the researchers in their report.

Reference

Piau A, Bourgade G, Berbon C, Nourhashemi F, Louit C, Balardy L. Access to individualized oncology care for older patients in complex healthcare networks: The skilled nurse option [published online November 15, 2019]. J Geriatr Oncol. doi: 10.1016/j.jgo.2019.10.014