A nurse-led geriatric assessment model was a feasible and sustainable way to integrate geriatric assessments into routine oncologic care, according to a poster presented by Polly Dufton, RN, PhD, of Austin Health, University of Melbourne, Australia, at the IASLC World Conference on Lung Cancer.
A comprehensive geriatric assessment identifies patients at high risk of adverse outcomes and has been shown to improve health-outcomes, quality of life, and reduction in health service use, Dufton explained.
In this study, Dufton and colleagues wanted to evaluate the implementation of a nurse-led model of geriatric oncology assessment in patients aged 65 or older with newly diagnosed lung cancer.
A nurse undertook an hour long face-to-face assessment incorporating six validated tools: G8, distress thermometer, timed up and go, mini-cog, hospital anxiety and depression scale, and the Elderly Functional Index. Individual cases were then discussed by a multidisciplinary team comprising nursing staff, a geriatrician and oncology. Referrals for further comprehensive geriatric assessment were made if deemed necessary.
The patients were followed every 3 weeks to assess the effect of these assessments on oncological treatment plans, treatment completion rates, and health care utilization.
Dufton presented results of the analysis where 64 patients were screened and 35 had undergone nurse-led assessments. The mean age of patients was 79 and 71% were male. The majority (94%) of patients had one or more comorbidities.
Three-quarters (74%) of patients had a G8 score of 14 or less, and almost one-third (29%) of patients were referred for a comprehensive geriatric assessment.
One-third of patients had an upfront dose or treatment modification. In comparison, historical data showed that 18% of patients aged 65 or older had upfront dose of treatment modification.
However, no participants have had their treatment discontinued due to treatment toxicity compared with historical data showing 10% of patients aged 65 or older with treatment discontinuation due to treatment toxicity.
These results show that a nurse-led model can reduce access to barriers to geriatric assessment and increase early identification of supportive care needs.
Implementation of a Nurse-led Geriatric Oncology Assessment Model in the Lung Cancer Care Pathway