Providing an oncologist with a geriatric assessment (GA) summary increased conversations about falls in a community oncology setting, according to a study published in JCO Oncology Practice.
“Falls are common among community-dwelling older adults with cancer, occurring under similar circumstances as among those without cancer,” study researchers wrote. “Although some studies have found no or negligible association between cancer diagnosis and falls, there is evidence that those with cancer fall more often.”
In this study, researchers used existing data from a nationwide cluster-randomized clinical trial that evaluated whether providing oncologists with a GA summary and GA-guided management recommendations improved patient satisfaction with communication about aging-related concerns. This secondary analysis generated odds ratios for the association of patient and oncologist characteristics with patient-oncologist conversations about falls.
Audio recordings were evaluable for 528 of 541 participating patients. Conversations about falls were six-times more common in patients assigned to the GA summary arm compared with the usual care arm (61.3% vs. 10.3%; P<.001).
When this was limited to only patients with prior falls, 73.7% of patients assigned to the GA summary arm had a conversation about falls compared with 17.1% of those in the usual care arm (P<.001).
“Our finding is that the intervention increased conversations about falls even among those patients with a history of falling adds to the rapidly accumulating evidence demonstrating the importance and utility of incorporating GA into oncology care,” the researchers wrote.
A history of falls (odds ratio [OR]=2.1; 95% CI, 1.3-3.6; P=.005) and impaired physical performance (OR=4.7; 95% CI, 1.7-12.8; P=.002) were both significantly associated with patient-oncologist conversations about falls after adjustment for intervention and practice sites.
The researchers acknowledged that data from a single oncology office visit do not capture discussions that may have occurred with other health care staff or at prior visits.
“Incorporating standardized assessments of fall risk factors and providing high-quality recommendations with their results may cue oncologists to initiate conversations about falls with older adult patients,” the researchers wrote. “This GA intervention has been shown to affect the quantity and quality of conversations regarding geriatric syndromes including polypharmacy, comorbidities, and physical function.”
Communication About Fall Risk in Community Oncology Practice: The Role of Geriatric Assessment