Feasibility of integrating geriatric oncology and palliative care assessment into the routine care of older adults in a community setting.

Authors

Ramy Sedhom

Ramy Sedhom

University of Pennsylvania, Philadelphia, PA

Ramy Sedhom , Noah A. Goldman , Kerri Celaya , Kari A Mastro , Paul Ortiz , David W. Dougherty

Organizations

University of Pennsylvania, Philadelphia, PA, Penn Medicine Princeton Health, Plainsboro, NJ, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA

Research Funding

No funding received
None.

Background: Emerging data support the value of geriatric assessment (GA) and palliative care (PC) domains in determining treatment for older adults with cancer. Limited data exist on the ability to integrate GA and PC in a community oncology clinic. The objective of this study was to determine the feasibility of integrating GA and PC screening in the community. Methods: Patients ≥ 75 were eligible. The GA included a health care provider assessment of performance status, cognitive function, functional status, psychological state, social support, and nutritional status. PC assessment included ESAS questionnaire, patient goals and values, advance care plans, and caregiver distress. Results: From September 2021 to Jan 2023, 131 consecutive older adults were assessed in one community clinic in the State of New Jersey, a satellite of the University of Pennsylvania. The median age was 82 (range 75-97). Using the VES-13 survey, 11% of patients were fit, 60% vulnerable and 29% frail. Issues were noted in cognition (11%), psychological state (27%), social support (38%), and nutrition (26%). The majority of patients prioritized quality of life over time (73%) and maintenance of independence was often cited as the most important goal (62%). Fewer than half of patients had formal advance directives (42%). 32% of the time, the final plan deviated from standard of care to align with patient/caregiver values. Conclusions: Integration of GA and PC is feasible in the community oncology setting. Further study is planned to evaluate the impact on patient and caregiver outcomes, and to standardize assessment for routine care across all Penn Medicine clinics.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Symptoms and Survivorship

Track

Symptom Science and Palliative Care

Sub Track

Geriatric Models of Care

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr e24024)

DOI

10.1200/JCO.2023.41.16_suppl.e24024

Abstract #

e24024

Abstract Disclosures

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