Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Geriatric Assessment (GA) in the Instagram era: adding photographs to electronic GA to enhance supportive care (ESC) of older adults with cancer  (#432)

Christopher Steer 1 2 3 4 , Darren Jayasuriya 2 , Nicole Webb 3 , Tshepo Rasekaba 4 , Kim Young 4 , Mira Kapur 2 , Stacey Rich 4 , Irene Blackberry 4
  1. Border Medical Oncology, Albury Wodonga Regional Cancer Centre, Albury, NSW, Australia
  2. UNSW School of Clinical Medicine, Rural Clinical Campus, , Albury, NSW, Australia
  3. Albury Wodonga Health, Albury Wodonga Regional Cancer Centre, Albury, NSW, Australia
  4. John Richards Centre for Rural Ageing Research, La Trobe University, Wodonga, VIC, Australia

Introduction: Multidimensional geriatric assessment (GA) of older patients with cancer has been shown to improve communication about age-related concerns including “What Matters Most”, reduce treatment toxicity and enable GA-guided supportive care.

Aims: To explore feasibility of adding Photovoice (PV) analysis of patient-derived photographs to an electronic GA to enhance supportive care (ESC) of older adults at Albury Wodonga Regional Cancer Centre.

Methods: Eligibility: Age >70yrs, assessed for treatment at AWRCC, G8 screening tool <14. Randomisation to GA using electronic rapid fitness assessment (eRFA) (+TUG and miniCOG) or eRFA + 4 patient-derived photographs and recorded interview using PhotoVoice SHOWeD questions (1).

Patients asked to provide photographs using 4 themes: 1. Identity 2. Something important to patient 3. Home environment 4. Transport. Thematic analysis of PV interview enabled creation of a 2-page summary for discussion at ESC MDM.

Results/ Outcomes: 18 patients randomised - eRFA alone (n=9),  eRFA+PV (n=9).  Median age = 78 yrs (range 72-90). Median G8 score = 11.5 (range 10-14).
Treatment intent: adjuvant (44%), curative (28%), palliative (22%), no treatment (6%). All patients completed eRFA (8 needed assistance). All patients on the eRFA+PV arm provided at least 2 photographs with 4 patients providing >4 photos.
Thematic analysis of PV interview enabled production of ESC summary sheet (Domains: Individual, Interpersonal Relationships, Community and Society, Transport and Home environment and Implications for treatment). Summary enabled insight into patient's lived experience and "What Matters Most". eRFA + ESC sheet + photos enabled patient-centred discussion at MDM and guided supportive care interventions.

Conclusion: Addition of patient-derived photographs and PV interview to a GA was feasible in older adults at a regional cancer centre and can be used to guide patient-centred, enhanced supportive care. Thematic analysis of recorded PV interview is not practical given time constraints however useful information may be derived from photographs alone.

 

  1. Wang CC, Yi WK, Tao ZW, Carovano K. Photovoice as a participatory health promotion strategy. Health promotion international. 1998 Jan 1;13(1):75-86.