Slavova-Boneva Vanya, Barrell Anne, Battisti Nicolò Matteo Luca
Senior Adult Oncology Programme, The Royal Marsden NHS Foundation Trust, London, UK.
Senior Adult Oncology Programme, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK.
Int J Clin Pharm. 2025 Feb 10. doi: 10.1007/s11096-025-01871-w.
Comprehensive geriatric assessment evaluates key health domains for older adults, focusing on medicine optimisation and medication adherence to improve tolerability and quality of life for older adults on systematic anticancer therapy. The Royal Marsden (RM) Senior Adult Oncology Programme (SAOP) provides multidisciplinary geriatric assessment and interventions for patients ≥ 70 undergoing systematic anticancer therapy.
We designed an ACCESS (eArly identifiCation advanCed gEriatric aSsesSment) tool to enhance efficiency of SAOP outpatient clinics by facilitating geriatric assessment including medications, nutrition, social support, mood, and functional assessments.
SAOP at RM NHS Foundation Trust, London, UK.
Developed by SAOP pharmacist and clinical nurse specialist with input from SAOP multidisciplinary team, the ACCESS tool includes medication review patient counselling deprescribing, and comorbidity management, aligning with the Royal Pharmaceutical Society Advanced Pharmacy Framework.
From January to December 2022, ACCESS was implemented in three steps: screening with Senior Adult Oncology Programme v 3 (SAOP3) questionnaire, remote consultation based on results, and medication review and patient counselling for complex medication needs, enhancing patient engagement and treatment understanding.
The practice was audited through the implementation process. Quantitative data from staff and 100 patients who were users of the SAOP service and ACCESS tool revealed higher medication adherence, improved identification of inappropriate medications, and enhanced confidence in managing complex geriatric oncology cases.
The ACCESS tool, led by clinical pharmacist and clinical nurse specialist has improved outpatient clinic efficiency, patient satisfaction, and healthcare coordination. It allows personalised follow-up plans for older adults with complex health issues on anticancer therapy. Regular multidisciplinary team meetings and digital health records enhance care coordination and decision-making for older adults with cancer.
综合老年评估评估老年人的关键健康领域，重点是优化药物治疗和药物依从性，以提高接受系统性抗癌治疗的老年人的耐受性和生活质量。皇家马斯登（RM）老年成人肿瘤项目（SAOP）为70岁及以上接受系统性抗癌治疗的患者提供多学科老年评估和干预措施。
我们设计了一种ACCESS（早期识别高级老年评估）工具，通过促进包括药物、营养、社会支持、情绪和功能评估在内的老年评估，提高SAOP门诊诊所的效率。
英国伦敦RM国民保健服务基金会信托基金的SAOP。
ACCESS工具由SAOP药剂师和临床护士专家开发，并得到SAOP多学科团队的投入，包括药物审查、患者咨询、减药和合并症管理，符合皇家药学会高级药房框架。
2022年1月至12月，ACCESS分三个步骤实施：使用老年成人肿瘤项目v3（SAOP3）问卷进行筛查、根据结果进行远程咨询，以及针对复杂药物需求进行药物审查和患者咨询，增强患者参与度和对治疗的理解。
通过实施过程对该实践进行审核。来自工作人员和100名使用SAOP服务和ACCESS工具的患者的定量数据显示，药物依从性更高，对不适当药物的识别得到改善，并且在管理复杂的老年肿瘤病例方面的信心增强。
由临床药剂师和临床护士专家主导的ACCESS工具提高了门诊诊所效率、患者满意度和医疗协调。它允许为接受抗癌治疗的有复杂健康问题的老年人制定个性化的随访计划。定期的多学科团队会议和数字健康记录增强了对患有癌症的老年人的护理协调和决策。
