Impact of care pathway for nursing home residents treated for cancer: ONCO-EHPAD study.

Autor: Couderc AL; Division of Internal Medicine, Geriatric and Therapeutic, University Hospital of Marseille (AP-HM), Marseille, France. anne-laure.couderc@ap-hm.fr.; Aix-Marseille Université, CNRS, EFS, ADES, Marseille, France. anne-laure.couderc@ap-hm.fr., Berbis J; Department of Public Health, EA 3279 Self-perceveid Health Assessment Research Unit, Medical School, Aix-Marseille University, Marseille, France.; Aix Marseille University, Marseille, France., Delalande G; Division of Internal Medicine, Geriatric and Therapeutic, University Hospital of Marseille (AP-HM), Marseille, France., Mugnier B; Division of Internal Medicine, Geriatric and Therapeutic, University Hospital of Marseille (AP-HM), Marseille, France.; Aix-Marseille Université, CNRS, EFS, ADES, Marseille, France., Courcier A; Division of Internal Medicine, Geriatric and Therapeutic, University Hospital of Marseille (AP-HM), Marseille, France., Bourriquen M; Division of Internal Medicine, Geriatric and Therapeutic, University Hospital of Marseille (AP-HM), Marseille, France.; Aix-Marseille Université, CNRS, EFS, ADES, Marseille, France., Rey D; Division of Internal Medicine, Geriatric and Therapeutic, University Hospital of Marseille (AP-HM), Marseille, France., Greillier L; Aix Marseille University, Marseille, France.; Division of Multidisciplinary Oncology and Therapeutic Innovations, AP-HM, Marseille, France., Baciuchka M; Division of Multidisciplinary Oncology and Therapeutic Innovations, AP-HM, Marseille, France., Sudour P; Division of research and innovation, AP-HM, Marseille, France., Agnelli L; Division of research and innovation, AP-HM, Marseille, France., Nouguerede E; Division of Internal Medicine, Geriatric and Therapeutic, University Hospital of Marseille (AP-HM), Marseille, France., Fabries S; Groupement de Coopération Sanitaire pour un Parcours Gérontologique dans l'Agglomération Marseillaise (GCS PGAM), Marseille, France., Villani P; Division of Internal Medicine, Geriatric and Therapeutic, University Hospital of Marseille (AP-HM), Marseille, France.; Aix-Marseille Université, CNRS, EFS, ADES, Marseille, France.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2021 Jul; Vol. 29 (7), pp. 3933-3942. Date of Electronic Publication: 2021 Jan 03.
DOI: 10.1007/s00520-020-05973-1
Abstrakt: Purpose: Few data are known about cancer management in frail nursing home residents.
Methods: Objective of our prospective, interventional study was to set up in the Marseille area, a care pathway for nursing homes residents with a suspected cancer. It combined cancer diagnosis procedures and comprehensive geriatric assessment (CGA), both made in our geriatric oncology outpatient unit, before oncologic advice for treatment decision. In standard care, CGA is carried out after therapeutic decision, to determine whether the planned treatment is compatible with the patient's frailties. CGA and quality of life were performed at enrolment and at 6 months. This study was registered in ClinicalTrials.gov (NCT03103659).
Results: Between April 2017 and March 2020, 48 residents from 38 nursing homes were included: 24 had the care pathway (PP), and 24 the standard care (NPP). Six were excluded (no cancer). PP had more frailties than NPP. All PP and 75% of NPP had outpatient care. Curative treatment was given to 77% of NPP (including chemotherapy in 10 cases), and 25% of PP (surgery, radiotherapy, hormone therapy). A majority of PP (75%) had supportive care. At 6 months, 16 patients died (11 NPP, 5 PP). Quality of life evolution was available for 11 PP and 7NPP: it showed stability in PP and degradation in NPP.
Conclusion: Even if part of residents were too frail to get curative treatment, the care pathway enabled them to benefit from oncologic advice and appropriate supportive care while preserving their quality of life. Further investigations are needed to confirm these findings.
Databáze: MEDLINE
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