Prospective Comparison of Geriatric Assessment and Provider's Assessment of Older Adults With Metastatic Breast Cancer in the Community.
breast cancer
clinical oncology
elderly
geriatric assessment
geriatrics
Journal
The oncologist
ISSN: 1549-490X
Titre abrégé: Oncologist
Pays: England
ID NLM: 9607837
Informations de publication
Date de publication:
04 03 2022
04 03 2022
Historique:
received:
22
02
2021
accepted:
24
09
2021
entrez:
31
5
2022
pubmed:
1
6
2022
medline:
3
6
2022
Statut:
ppublish
Résumé
Geriatric assessment (GA) is recommended for evaluating fitness of an older adult with cancer. Our objective was to prospectively evaluate the gaps that exist in the assessment of older adults with metastatic breast cancer (OA-MBC) in community practices (CP). Self-administered GA was compared to provider's assessment (PA) of patients living with MBC aged ≥65 years treated in CP Providers were blinded to the GA results until PA was completed. McNemar's test was used to detect differences between PA and GA. One hundred patients were enrolled across 9 CP (median age 73.9). Geriatric assessment detected a total of 356 abnormalities in 96 patients; of which, 223 required interventions. African American and widowed/single patients were more likely to have abnormalities identified by GA. On average, across 100 patients, PA did not detect 25.5% of GA-detected abnormalities, mostly in functional status, social support, nutrition, and cognition. These differences were less pronounced among providers with more clinical experience. Patients with abnormal Timed Up and Go tests more likely had additional abnormalities in other domains, and more abnormalities that were not identified by PA. Providers were "surprised" by GA results in 33% of cases, mainly with cognitive or social support findings, and reported plans for management change for 39% of patients based on GA findings. Including a GA in the care of OA-MBC in CP is beneficial for the detection of multiple abnormalities not detected by routine PA.
Sections du résumé
BACKGROUND
Geriatric assessment (GA) is recommended for evaluating fitness of an older adult with cancer. Our objective was to prospectively evaluate the gaps that exist in the assessment of older adults with metastatic breast cancer (OA-MBC) in community practices (CP).
METHODS
Self-administered GA was compared to provider's assessment (PA) of patients living with MBC aged ≥65 years treated in CP Providers were blinded to the GA results until PA was completed. McNemar's test was used to detect differences between PA and GA.
RESULTS
One hundred patients were enrolled across 9 CP (median age 73.9). Geriatric assessment detected a total of 356 abnormalities in 96 patients; of which, 223 required interventions. African American and widowed/single patients were more likely to have abnormalities identified by GA. On average, across 100 patients, PA did not detect 25.5% of GA-detected abnormalities, mostly in functional status, social support, nutrition, and cognition. These differences were less pronounced among providers with more clinical experience. Patients with abnormal Timed Up and Go tests more likely had additional abnormalities in other domains, and more abnormalities that were not identified by PA. Providers were "surprised" by GA results in 33% of cases, mainly with cognitive or social support findings, and reported plans for management change for 39% of patients based on GA findings.
CONCLUSIONS
Including a GA in the care of OA-MBC in CP is beneficial for the detection of multiple abnormalities not detected by routine PA.
Identifiants
pubmed: 35641214
pii: 6526427
doi: 10.1093/oncolo/oyab032
pmc: PMC8895742
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e133-e141Subventions
Organisme : NCI NIH HHS
ID : P30 CA006927
Pays : United States
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press.
Références
Cancer. 2005 Nov 1;104(9):1998-2005
pubmed: 16206252
J Gerontol A Biol Sci Med Sci. 2013 Apr;68(4):441-6
pubmed: 22987796
Br J Nutr. 2012 Jul;108(2):343-8
pubmed: 22142968
J Gerontol A Biol Sci Med Sci. 2015 Sep;70(9):1148-55
pubmed: 25834194
J Natl Compr Canc Netw. 2018 Mar;16(3):301-309
pubmed: 29523669
J Natl Compr Canc Netw. 2013 Dec 1;11(12):1494-502
pubmed: 24335684
Lancet. 2021 Nov 20;398(10314):1894-1904
pubmed: 34741815
Clin Oncol (R Coll Radiol). 2020 Sep;32(9):553-561
pubmed: 32684503
J Oncol Pract. 2017 Nov;13(11):e900-e908
pubmed: 28837375
Geriatrics (Basel). 2019 Jun 24;4(2):
pubmed: 31238518
Am J Clin Oncol. 1982 Dec;5(6):649-55
pubmed: 7165009
J Clin Oncol. 2012 Jun 10;30(17):2128-33
pubmed: 22585687
J Clin Oncol. 2006 Mar 1;24(7):1105-11
pubmed: 16505430
Breast. 2011 Aug;20(4):293-6
pubmed: 21530254
J Am Geriatr Soc. 1991 Feb;39(2):142-8
pubmed: 1991946
JAMA Oncol. 2021 Nov 01;7(11):e214158
pubmed: 34591080
J Geriatr Oncol. 2011 Apr;2(2):121-129
pubmed: 21927633
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
J Clin Oncol. 2011 Apr 1;29(10):1290-6
pubmed: 21357782
Arch Intern Med. 2008 Oct 13;168(18):2033-40
pubmed: 18852406
Eur J Cancer. 2012 Apr;48(6):805-12
pubmed: 21741826
J Am Geriatr Soc. 2005 Apr;53(4):695-9
pubmed: 15817019
Cancer. 2012 Jul 1;118(13):3377-86
pubmed: 22072065
Am Soc Clin Oncol Educ Book. 2019 Jan;39:e96-e109
pubmed: 31099668
J Psychiatr Res. 1982-1983;17(1):37-49
pubmed: 7183759
J Oncol. 2016;2016:6186543
pubmed: 27066075
Soc Sci Med. 1991;32(6):705-14
pubmed: 2035047
J Clin Oncol. 2018 Aug 1;36(22):2326-2347
pubmed: 29782209
J Clin Oncol. 2013 Nov 1;31(31):3869-76
pubmed: 24062405
Clinics (Sao Paulo). 2015 May;70(5):369-72
pubmed: 26039955
J Biomed Inform. 2019 Jul;95:103208
pubmed: 31078660
J Geriatr Oncol. 2015 Jul;6(4):254-61
pubmed: 25976445
Psychopharmacol Bull. 1988;24(4):609-14
pubmed: 3074322