Use of Geriatric Assessment Improves Communication, Comorbidity Management in Older Patients With Cancer

A general conversation with cancer patients about the impact their comorbidities have on their daily lives could be a key to ensuring they get the care they need.

With that idea in mind, a team of researchers set out to learn more about the potential benefits of a geriatric assessment (GA)-guided intervention upon the conversations that oncologist have with their patients with advanced cancer regarding comorbidities. The findings were published in JCO Oncology Practice.

This study was a secondary mixed methods analysis of information from a national multisite cluster-randomized trial. To be eligible for that study, patients had to be 70 years or older with advanced cancer and at least 1 comorbidity that caused impairment or interfered with their activities of daily living. All participants underwent GA. The Older Americans Resources and Services Comorbidity questionnaire was used to assess for 15 comorbidities and their interference with daily activities.

From that study, the researchers recruited 541 elderly cancer participants from 30 community oncology practice clusters who had an average of 3.2 comorbidities. In the intervention arm, the oncologists, patients, and caregivers received a summary of the GA with a list of recommendations for addressing the patients’ specific impairments. In the usual-care arm, the oncology team only received an alert if clinically significant cognitive impairment and/or depression were diagnosed in the participant.

“We demonstrated that providing a GA-guided intervention to oncologists more than doubled the number of conversations that occurred with patients regarding comorbidities, especially related to diabetes, cardiovascular disease, and other conditions that can directly affect cancer care,” the researchers wrote. “Furthermore, the GA-guided intervention prompted oncologists to adequately address patients’ comorbidities three times more often than when the intervention was not provided.”

The researchers noted that quality conversations between patients and healthcare providers may lead to greater patient satisfaction, which can, in turn, lead to better compliance with treatments.

The study was limited by several factors. Nearly 90% of the participants were non-Hispanic white; therefore, the results might not be generalizable to other races or ethnicities. The analyses were conducted based on information from 1 clinic visit which might not be representative, the researchers cautioned.

The researchers called for future research to follow up on the effectiveness of this type of action plan on specific health outcomes. “These practices have the potential to improve patient satisfaction with cancer care and properly manage comorbidities during treatment of their advanced cancer,” they concluded.

Disclosures: This research was supported by Patient-Centered Outcomes Research Institute, National Institutes of Health (NIH) National Cancer Institute (NCI); NIH National Institute on Aging; the University of Rochester CTSA Award No. KL2TR001999. Multiple authors have declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Kleckner AS, Wells M, Kehoe LA, et al. Using geriatric assessment to guide conversations regarding comorbidities among older patients with advanced cancer. JCO Oncol Pract. Published online July 6, 2021. doi:10.1200/OP.21.00196