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Integrating geriatric assessment into routine gastrointestinal (GI) consultation: The Cancer and Aging Resilience Evaluation (CARE).

作者信息

Williams Grant R, Kenzik Kelly M, Parman Mariel, Al-Obaidi Mustafa, Francisco Liton, Rocque Gabrielle B, McDonald Andrew, Paluri Ravi, Navari Rudolph M, Nandagopal Lakshmin, Gbolahan Olumide, Young-Smith Crystal, Robertson Matthew, Bhatia Smita

机构信息

Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, United Kingdom; Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, United Kingdom.

Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, United Kingdom; Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, United Kingdom.

出版信息

J Geriatr Oncol. 2020 Mar;11(2):270-273. doi: 10.1016/j.jgo.2019.04.008. Epub 2019 Apr 18.


DOI:10.1016/j.jgo.2019.04.008
PMID:31005648
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6801013/
Abstract

BACKGROUND: Integrating Geriatric Assessment (GA) in the management of older adults with cancer is recommended, yet rarely practiced in routine oncologic care. Our objective was to assess the feasibility of integrating routine GA in the management of older adults with gastrointestinal (GI) malignancies and characterize impairments in this population. METHODS: Patients ≥60yo referred for consultation to the GI Oncology clinic were asked to complete the Cancer and Aging Resilience Evaluation (CARE) on their first visit. CARE was adapted from the Cancer and Aging Research Group GA with modifications to create a completely patient-reported version of the GA. Feasibility was defined as completion of CARE by ≥80% of eligible patients during the initial consultation. RESULTS: Of the eligible 354 new patients seen in the GI Oncology Clinic, 323 (91.2%) completed the CARE survey. Most patients (83.1%) felt the length of time to complete was appropriate (median time of 10 min [IQR 10-15.7 min]). GA impairments were prevalent: 54.7% reported dependence in Instrumental Activities of Daily Living, 15.5% reported dependence in Activities of Daily Living, 20.9% reported ≥1 fall, 35.9% reported a performance status ≥2, 55.7% were limited in walking one block, 74.0% reported polypharmacy (≥4 medications), and 36.4% had ≥3 comorbidities. CONCLUSIONS: Performing a GA in the routine care of older adults with GI malignancies is feasible, and GA impairments are common among this population. A fully patient-reported GA such as the CARE may facilitate broader incorporation of GA in the routine clinic work flow.

摘要

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本文引用的文献

[1]
Self-endorsed cognitive problems versus objectively assessed cognitive impairment in blood or bone marrow transplantation recipients: A longitudinal study.

Cancer. 2020-5-15

[2]
Baseline Cognition Assessment Among Patients With Oropharyngeal Cancer Using PROMIS and NIH Toolbox.

JAMA Otolaryngol Head Neck Surg. 2018-11-1

[3]
Community Oncologists' Decision-Making for Treatment of Older Patients With Cancer.

J Natl Compr Canc Netw. 2018-3

[4]
Geriatric Assessment: Precision Medicine for Older Adults With Cancer.

J Oncol Pract. 2018-2

[5]
Time to Stop Saying Geriatric Assessment Is Too Time Consuming.

J Clin Oncol. 2017-9-1

[6]
NCCN Guidelines Insights: Older Adult Oncology, Version 2.2016.

J Natl Compr Canc Netw. 2016-11

[7]
Comprehensive Geriatric Assessment-Guided Therapy Does Improve Outcomes of Older Patients With Advanced Lung Cancer.

J Clin Oncol. 2016-11-20

[8]
Subjective or Objective Measures of Cognitive Functioning-What's More Important?

JAMA Oncol. 2016-10-1

[9]
Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research.

J Geriatr Oncol. 2016-7-5

[10]
Validation of a Prediction Tool for Chemotherapy Toxicity in Older Adults With Cancer.

J Clin Oncol. 2016-7-10

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