Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Department of Thoracic Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico.
JCO Glob Oncol. 2022 Mar;8:e2100390. doi: 10.1200/GO.21.00390.
There is limited information regarding the use of the geriatric assessment (GA) for older adults with cancer in developing countries. We aimed to describe geriatric oncology practice among Mexican oncology professionals and to identify barriers and facilitators for the implementation of GA into the routine care of older adults with cancer in Mexico.
We conducted an explanatory sequential mixed-methods study. We administered an online survey to cancer specialists in Mexico about the routine use of GA and barriers for its use. We then conducted online semistructured interviews with survey respondents selected by their use of GA, expanding on barriers and facilitators for performing GA. Descriptive statistical analyses were performed for quantitative data; qualitative data were analyzed inductively through thematic analysis. We developed joint displays to integrate quantitative/qualitative results.
We obtained 196 survey responses: 37 physicians (18.9%) reported routinely performing a GA. Medical oncologists ( = .002) and physicians seeing ≤ 10 patients/day ( = .010) were more likely to use GA. The most frequent barriers for GA use were lack of qualified personnel (49%), limited knowledge (43.9%), and insufficient time (37.2%). In the interviews (n = 22), the limited availability of geriatricians was commonly mentioned. Respondents highlighted the lack of geriatric oncology knowledge among cancer specialists and geriatricians. Saturation of oncology services and a lack of effective referral pathways for GA were also common issues. Facilitators included availability of geriatricians, system/administrative facilitators, presence of a multidisciplinary team, and availability of geriatric oncology education.
The routine use of geriatric oncology principles in Mexico is limited by the availability of qualified personnel and by insufficient knowledge. An educational intervention could improve the implementation of GA in cancer care.
有关发展中国家老年癌症患者使用老年评估（GA）的信息有限。我们旨在描述墨西哥肿瘤学专业人员的老年肿瘤学实践，并确定在墨西哥将 GA 纳入老年癌症患者常规护理的障碍和促进因素。
我们进行了一项解释性序贯混合方法研究。我们向墨西哥的癌症专家发放了一份关于 GA 的常规使用以及使用障碍的在线调查。然后，我们根据使用 GA 的情况，对调查对象进行了在线半结构化访谈，进一步探讨了进行 GA 的障碍和促进因素。对定量数据进行描述性统计分析；对定性数据进行归纳分析，通过主题分析进行分析。我们开发了联合展示，以整合定量/定性结果。
我们共获得 196 份调查回复：37 名医生（18.9%）报告常规进行 GA。进行医学肿瘤学（P =.002）和每天看诊≤10 名患者的医生（P =.010）更有可能使用 GA。GA 使用的最常见障碍是缺乏合格人员（49%）、知识有限（43.9%）和时间不足（37.2%）。在访谈（n = 22）中，经常提到老年科医生的可用性有限。受访者强调癌症专家和老年科医生缺乏老年肿瘤学知识。肿瘤学服务的饱和以及 GA 缺乏有效的转介途径也是常见问题。促进因素包括老年科医生的可用性、系统/行政促进因素、多学科团队的存在以及老年肿瘤学教育的可用性。
在墨西哥，老年肿瘤学原则的常规使用受到合格人员的可用性和知识不足的限制。教育干预可能会改善癌症护理中 GA 的实施。
