Bernadette Kelly1, Martine Waters2, Stella Snape-Jenkinson3, Hermione Wheatley4
1Redcliffe Hospital , Redcliffe, Australia, 2Royal Brisbane Hospital, Herston, Australia, 3Caboolture Hospital , Caboolture, Australia, 4North Lakes Health Precinct, North Lakes, Australia
Comprehensive Geriatric Assessment (CGA) has been shown to predict survival and treatment toxicity in elderly patients on chemotherapy. Identification and management of deficits improves patients’ health-related quality of life by reducing symptom burden, reducing unplanned admissions and reducing early treatment discontinuation. Despite evidence in the literature supporting the usefulness of routine assessment in older patients, an evidence based, age appropriate assessment is not widely applied in cancer care.
2 metropolitan cancer care centres piloted an Allied Health/ Nursing led geriatric oncology screening and assessment program using validated tools to identify patient needs and offer targeted interventions to support older patients through their treatment.
Patient participation in a CGA was lower than expected, with 47% of recommended patients completing the assessment. In descending order, Timed Up and Go, malnutrition risk, depression and social support constituted the highest volume of referrals arising from CGA accounting for more than half of the identified deficits. Pain, fatigue, cognition, falls, iADL and continence were the least identified areas of overall need collectively accounting for less than 20%.
Service improvement is underway to review evidence supporting the tools used in the CGA to identify need in this population. Fatigue, falls, iADL, BMI and social support tools have been updated following this process. The data aggregation platform (QOOL) is being updated to automate and streamline process reducing variation and allowing the program to be scaled to other sites. This data also includes reasons why patients decline assessment and/or interventions, and outcome of interventions.
Acknowledgement to all Allied Health, Nursing and Medical staff across Cancer Care Services at Redcliffe Hospital, Caboolture Hospital and Northlakes Health Precinct involved in the development, implementation and review of the Geriatric Oncology Service across Metro North HHS.
Bernadette Kelly is a Senior Occupational Therapist working within the Cancer Care Service at Redcliffe Hospital in Metro North HSS, QLD. She has worked in Oncology and Palliative Care for the past 14 years including the Geriatric Oncology Service since it’s establishment in 2018. She has been involved in completing geriatric oncology screening and comprehensive geriatric assessment (CGA) within this service as well as providing specific Occupational Therapy interventions to this population.