Prospective Comparison of Geriatric Assessment and Provider's Assessment of Older Adults With Metastatic Breast Cancer in the Community.

Autor:	Seedor RS; Department of Medical Oncology, Sidney Kimmel Cancer Center, Jefferson Health, Philadelphia, PA, USA., Meeker CR; Cancer Prevention and Control Department, Fox Chase Cancer Center, Philadelphia, PA, USA., Lewis B; Cancer Prevention and Control Department, Fox Chase Cancer Center, Philadelphia, PA, USA., Handorf EA; Biostatistics Department, Fox Chase Cancer Center, Philadelphia, PA, USA., Filchner KA; Cancer Prevention and Control Department, Fox Chase Cancer Center, Philadelphia, PA, USA., Varadarajan R; Medical Oncology Hematology Consultants, Christiana Care Helen F. Graham Cancer Center & Research Institute, Newark, DE, USA., Hensold J; Bozeman Health Cancer Center, Bozeman, MT, USA., Padmanabhan A; Medical Oncology Department, Fox Chase Cancer Center at Temple University Hospital, Philadelphia, PA, USA., Negin B; Southern Oncology Hematology Associates, Vineland, NJ, USA., Blankstein K; Hunterdon Hematology Oncology, Flemington, NJ, USA., Chawla NR; AtlantiCare Cancer Care Institute, Egg Harbor Township, NJ, USA., Song WF; Pottstown Hospital Tower Health, Pottstown, PA, USA., Epstein J; Cancer Prevention and Control Department, Fox Chase Cancer Center, Philadelphia, PA, USA., Winn J; Medical Oncology Department, Fox Chase Cancer Center, Philadelphia, PA, USA., Goldstein LJ; Medical Oncology Department, Fox Chase Cancer Center, Philadelphia, PA, USA., Dotan E; Medical Oncology Department, Fox Chase Cancer Center, Philadelphia, PA, USA.
Jazyk:	angličtina
Zdroj:	The oncologist [Oncologist] 2022 Mar 04; Vol. 27 (2), pp. e133-e141.
DOI:	10.1093/oncolo/oyab032
Abstrakt:	Background: Geriatric assessment (GA) is recommended for evaluating fitness of an older adult with cancer. Our objective was to prospectively evaluate the gaps that exist in the assessment of older adults with metastatic breast cancer (OA-MBC) in community practices (CP). Methods: Self-administered GA was compared to provider's assessment (PA) of patients living with MBC aged ≥65 years treated in CP Providers were blinded to the GA results until PA was completed. McNemar's test was used to detect differences between PA and GA. Results: One hundred patients were enrolled across 9 CP (median age 73.9). Geriatric assessment detected a total of 356 abnormalities in 96 patients; of which, 223 required interventions. African American and widowed/single patients were more likely to have abnormalities identified by GA. On average, across 100 patients, PA did not detect 25.5% of GA-detected abnormalities, mostly in functional status, social support, nutrition, and cognition. These differences were less pronounced among providers with more clinical experience. Patients with abnormal Timed Up and Go tests more likely had additional abnormalities in other domains, and more abnormalities that were not identified by PA. Providers were "surprised" by GA results in 33% of cases, mainly with cognitive or social support findings, and reported plans for management change for 39% of patients based on GA findings. Conclusions: Including a GA in the care of OA-MBC in CP is beneficial for the detection of multiple abnormalities not detected by routine PA. (© The Author(s) 2022. Published by Oxford University Press.)
Databáze:	MEDLINE
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