Cabrera-Jaime Sandra, Hernández-Marfil Anais, Adamuz-Tomas Jordi, Sánchez-Martín Silvia
Author Affiliations: Department Research, Catalan Institute of Oncology-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona; GRIN Group, IDIBELL, Institute of Biomedical Research; NURECARE-IGTP Foundation, Badalona (Dr Cabrera-Jaime); Hospital Universitari de Bellvitge; Universitat de Barcelona; GRIN Group, IDIBELL (Dr Adamuz-Tomas); and Oncology Nursing Department, Catalan Institute of Oncology-Hospital Germans Trias i Pujol (Mrs Hernández-Marfil and Mrs Sánchez-Martín), Spain.
Cancer Nurs. 2024 Nov 5. doi: 10.1097/NCC.0000000000001421.
The International Society of Geriatric Oncology recommends that all older people with cancer have a geriatric evaluation before beginning treatment.
To determine the prevalence of frailty in people 75 years and older diagnosed with lung or gynecological cancer and evaluate the adaptation of standard therapeutic strategies based on frailty, following the implementation of telephone-based frailty screening with the Vulnerable Elders Survey (VES-13).
INTERVENTIONS/METHODS: We performed a retrospective observational study in 362 people screened by an advanced practice nurse before their first oncology appointment. We collected secondary data from electronic medical records. The main variables were degree of frailty (according to VES-13 and comprehensive geriatric assessment), type of cancer treatment (standard and prescribed), treatment completion, sociodemographic characteristics, and comorbidities.
The VES-13 detected 186 people (51.4%) at risk of health deterioration, and the comprehensive geriatric assessment confirmed some degree of frailty in 157 people (43.4%), with a κ coefficient of 0.84. People with more comorbidities, greater frailty, and more geriatric syndromes were more likely to need treatment readjustment ( P < .001).
Telephone-based frailty screening by an advanced practice nurse showed high applicability, with very good agreement between the proportion of people classified as frail before the initial visit and in the subsequent geriatric assessment.
A protocol for establishing frailty risk through telephone screening by an advanced practice nurse facilitates the care process and helps clinicians adapt therapeutic decision-making to the needs of each patient and their family.
国际老年肿瘤学会建议，所有老年癌症患者在开始治疗前都应进行老年评估。
确定75岁及以上被诊断为肺癌或妇科癌症的人群中衰弱的患病率，并在采用脆弱老年人调查（VES-13）进行基于电话的衰弱筛查后，评估基于衰弱的标准治疗策略的适应性。
干预措施/方法：我们对362名在首次肿瘤门诊预约前由高级执业护士进行筛查的患者进行了一项回顾性观察研究。我们从电子病历中收集了二手数据。主要变量包括衰弱程度（根据VES-13和综合老年评估）、癌症治疗类型（标准和处方）、治疗完成情况、社会人口学特征和合并症。
VES-13检测出186人（51.4%）有健康恶化风险，综合老年评估确认157人（43.4%）有一定程度的衰弱，κ系数为0.84。合并症更多、衰弱程度更高和老年综合征更多的患者更有可能需要调整治疗（P < .001）。
由高级执业护士进行的基于电话的衰弱筛查显示出很高的适用性，初诊前被归类为衰弱的人群比例与随后的老年评估之间具有很好的一致性。
通过高级执业护士进行电话筛查来确定衰弱风险的方案有助于护理过程，并帮助临床医生根据每个患者及其家庭的需求调整治疗决策。
