Cook Simon, Munteanu Cosmin, Papadopoulos Efthymios, Abrams Howard, Stinson Jennifer N, Pitters Eric, Stephens Douglas, Lumchick Margaret, Emmenegger Urban, Koneru Rama, Papadakos Janet, Shahrokni Armin, Durbano Sara, Menjak Ines, Mehta Rajin, Haase Kristen, Jang Raymond, Krzyzanowska Monika K, Dale Craig, Jones Jennifer, Lemonde Manon, Alibhai Shabbir, Puts Martine
Technologies for Aging Gracefully Lab, University of Toronto, Toronto, Canada.
Department of Medicine, University Health Network, Toronto, Canada.
J Geriatr Oncol. 2023 Jan;14(1):101384. doi: 10.1016/j.jgo.2022.09.013. Epub 2022 Oct 8.
Geriatric assessment (GA) provides information on key health domains of older adults and is recommended to help inform cancer treatment decisions and cancer care. However, GA is not feasible in many health institutions due to lack of geriatric staff and/or resources. To increase accessibility to GA and improve treatment decision making for older adults with cancer (≥65 years), we developed a self-reported, electronic geriatric assessment tool: Comprehensive Assessment for My Plan (CHAMP).
Older adults with cancer were invited to join user-centered design sessions to develop the layout and content of the tool. Subsequently, they participated in usability testing to test the usability of the tool (ease of use, acceptability, etc.). Design sessions were also conducted with oncology clinicians (oncologists and nurses) to develop the tool's clinician interface. GA assessment questions and GA recommendations were guided by a systematic review and Delphi expert panel.
A total of seventeen older adults participated in the study. Participants were mainly males (82.4%) and 75% were aged 75 years and older. Nine oncology clinicians participated in design sessions. Older adults and clinicians agreed that the tool was user-friendly. Domains in the final CHAMP tool (with questions and recommendations) included functional status, falls risk, cognitive impairment, nutrition, medication review, social supports, depression, substance use disorder, and miscellaneous items.
CHAMP was designed for use by older adults and oncologists and may enhance access to GA for older adults with cancer. The next phase of the CHAMP study will involve field validation in oncology clinics.
老年评估(GA)可提供有关老年人关键健康领域的信息,推荐其用于辅助癌症治疗决策及癌症护理。然而,由于缺乏老年医学工作人员和/或资源,GA在许多医疗机构中并不可行。为提高老年癌症患者(≥65岁)获得GA的机会并改善治疗决策,我们开发了一种自我报告的电子老年评估工具:我的计划综合评估(CHAMP)。
邀请老年癌症患者参加以用户为中心的设计会议,以确定该工具的布局和内容。随后,他们参与可用性测试,以检验该工具的易用性(使用便捷性、可接受性等)。还与肿瘤临床医生(肿瘤学家和护士)进行了设计会议,以开发该工具的临床医生界面。GA评估问题和GA建议由系统评价和德尔菲专家小组指导。
共有17名老年人参与了该研究。参与者主要为男性(82.4%),75%的年龄在75岁及以上。9名肿瘤临床医生参与了设计会议。老年人和临床医生一致认为该工具对用户友好。最终CHAMP工具(包含问题和建议)的领域包括功能状态、跌倒风险、认知障碍、营养、用药审查、社会支持、抑郁、物质使用障碍及其他项目。
CHAMP旨在供老年人和肿瘤学家使用,可能会增加老年癌症患者获得GA的机会。CHAMP研究的下一阶段将涉及在肿瘤诊所进行实地验证。