Capacity to provide specialized care for older adults in community oncology practices: Results of the NCI Community Oncology Research Program (NCORP) Landscape survey.

Authors

Grant Richard Williams

Grant Richard Williams

University of Alabama at Birmingham, Birmingham, AL

Grant Richard Williams , Kathryn E. Weaver , Glenn Jay Lesser , Emily Van Meter Dressler , Karen Marie Winkfield , Heather B. Neuman , Anne Kazak , Ruth Carlos , Lucy Jean Gansauer , Charles Stewart Kamen , Joseph M. Unger , Supriya Gupta Mohile , Heidi D. Klepin

Organizations

University of Alabama at Birmingham, Birmingham, AL, Wake Forest School of Medicine, Winston-Salem, NC, Wake Forest Baptist Medical Center, Winston-Salem, NC, Wake Forest University, Winston-Salem, NC, Massachusetts General Hospital, Boston, MA, University of Wisconsin, Madison, WI, Children's Hospital of Philadelphia, Philadelphia, PA, University of Michigan, Farmington, MI, Spartanburg Regional Medical Center, Spartanburg, SC, University of Rochester Medical Center, Rochester, NY, Fred Hutchinson Cancer Research Center, Seattle, WA, Comprehensive Cancer Center, Wake Forest Baptist Health, Winston Salem, NC

Research Funding

U.S. National Institutes of Health

Background: American Society of Clinical Oncology guidelines recommend that patients ≥65 years of age starting chemotherapy undergo a geriatric assessment (GA) to inform and guide management; however, little is known about resources available in community oncology practices to facilitate geriatric specialty care and implement these guidelines. Methods: Community oncology practices were electronically surveyed in 2017 regarding the availability of various providers, supportive services, and practice characteristics, as part of a larger survey of cancer care delivery research (CCDR) capacity at NCORP sites. Designated CCDR leads provided information about their site. Descriptive statistics were used to report prevalence of resources available at each community practice. Results: Of the 925 NCORP practice locations, 504 (54%) responded to the survey, representing 227 practice groups. Of respondents, 58% included a free-standing clinic or private/group practice and 82% included inpatient services. The median number of new cancer cases per year ≥65 years of age was 443 (Interquartile range [IQR] 220-903). The median number of medical oncology providers was 5 (IQR 3-11). Only 1.8% of practices had a dual fellowship trained geriatric oncologist on staff. Geriatricians were available for consultation or co-management for 34% of sites, but only 13% of those had availability within the oncology clinic. Among those with access to geriatricians, consultations were primarily outpatient (90%) versus inpatient (54%). Ancillary services that could support GA were variably available onsite: social work (83%), nurse navigators (78%), pharmacist (77%), dietician (69%), supportive caregiver services (62%), rehabilitative medicine (57%), psychologist (41%), and psychiatrist (39%). Most sites utilized electronic health record systems (84%) and patient portals (89%). Conclusions: Availability of geriatric-trained providers is limited in community oncology practices. Use of primarily self-administered GA tools that direct referrals to available ancillary services may be an effective implementation strategy for guideline-based care.

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Health Services Research, Clinical Informatics, and Quality of Care

Track

Quality Care/Health Services Research

Sub Track

Care Delivery/Models of Care

Citation

J Clin Oncol 37, 2019 (suppl; abstr 6539)

DOI

10.1200/JCO.2019.37.15_suppl.6539

Abstract #

6539

Poster Bd #

230

Abstract Disclosures

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