Background
Cancer treatment planning in older people is complex. Little research has examined the integration of results from a geriatric assessment (GA) into treatment planning at multidisciplinary meetings (MDMs). We aimed to pilot a model of care incorporating information from a GA into the treatment planning process and to assess its utility and feasibility.
Methods
People aged >70 years with a new diagnosis of cancer completed a screening GA (1). Using information from this tool, the following were presented during MDMs: participants’ categorization as fit or vulnerable/frail, predicted toxicity from treatment, life expectancy without cancer and self reported ECOG performance status. Health professionals (HPs) were surveyed and structured interviews conducted to determine the usefulness of this intervention.
Results
65 patients were recruited across 4 tertiary institutions. 47 (72%) were discussed in a MDM and had the study specific information available: median age 76, (range 70-89), 59% female, 51% breast MDM, 32% lung MDM, 17% upper GI MDM. 59 HPs completed the questionnaire (RR 66%). Of the 45 HPs who were aware of the study, 80% found the additional information useful during treatment planning. 48% reported modifying their treatment recommendations based on this information and 80% felt “much more” or “a bit more confident” that their recommendations were suitable for the patient discussed. 86% of HPs wanted the study to continue into routine care. When interviewed, HPs were supportive of the intervention and found results reflected their clinical assessment. Further education regarding how HPs should interpret the presented data could improve the impact of this intervention on MDM treatment planning.
Conclusions
HPs found the incorporation of elements of GA useful when developing treatment recommendations at MDM. A larger clinical trial is warranted to determine whether inclusion of this, or similar, information can influence patient outcomes.