[Abstract] Geriatric Assessment Adoption in Community Cancer Centers: Trends, Barriers, and Recommendations

Presenters

E. Plotkin¹, L. Lucas¹, E. Dotan², G. Nightingale³, K.P. Loh⁴, P.S. Burhenn⁵, P. Allen⁶, R. Oyer⁷, M. Karuturi⁸, S. Lichtman⁹.
¹Association of Cancer Care Centers, Provider Education, Rockville, USA.
²Fox Chase Cancer Center, Hematology/Oncology Fellowship Training Program, Philadelphia, USA.
³Jefferson Health, Senior Adult Oncology Center, Philadelphia, USA.
⁴University of Rochester Medical Center, Oncology, Rochester, USA.
⁵City of Hope, Geriatric Oncology, Duarte, USA.
⁶LSU Life Course and Aging Center, Aging and Geriatrics, Baton Rouge, USA.
⁷Penn Medicine- Lancaster General Health- Ann B. Barshinger Cancer Institute, Oncology, Lancaster, USA.
⁸MD Anderson Cancer Center, Breast Medical Oncology, Houston, USA.
⁹Memorial Sloan Kettering Cancer Center, Gynecologic Oncology, Commack, USA.

Introduction

Addressing the needs of older adults with cancer is critical for the delivery of high-quality, patient-centered care. The Association of Cancer Care Centers (ACCC) has identified barriers and best practices for serving this growing patient population in order to help support the multidisciplinary team in understanding and performing this type of care.

Methods

A online survey was administered to 332 cancer professionals of differing size and region. Three multidisciplinary, in-depth focus groups were conducted.

Results

95% of survey respondents agreed that their older adult patients would benefit from a comprehensive geriatric assessment (CGA), yet only 17% are performing CGAs. Top barriers to this were time/personnel and familiarity with validated tools. Techniques for evaluating fitness, cognitive status, psychological status, comorbidities, and toxicity risk were often informal. To evaluate psychological status or depression 55% use the NCCN distress thermometer, 36% the patient interview, and 34% ask the patient directly if they're depressed. >25% of respondents don’t evaluate cognitive status at all, and 54% (top answer) ask simple questions to assess orientation. When abnormalities from CGA were identified, 83% noted referral to supportive services as the most common step, followed by discussing the results with patient/family and coordinating with appropriate specialties. Challenges with palliative care referrals were prevalent, with 68% reporting that patients don’t understand the benefit, 55% saying it’s occurring late in the treatment experience, and 40% claiming physicians don’t understand the benefit.

Conclusion

ACCC has compiled resources to address deficits in care, particularly in the community or lower-resourced settings at accc-cancer.org/geriatric.