Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Implementation of geriatric assessments in cancer care: an umbrella review (#342)

Sharon He 1 , Heather Shepherd 2 , Meera Agar 3 , Joanne Shaw 1
  1. School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW, Australia
  2. Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
  3. Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia

Aims

Geriatric assessments (GA) can assist with identifying older cancer patients at risk of treatment complications and guide treatment decision-making. However, there is uncertainty about what defines a GA in cancer care and the factors that impact on GA implementation in oncology settings. The aim of this umbrella review was to summarise and synthesise the evidence for i) what constitutes a GA in cancer care, ii) how a GA is conducted, iii) which outcomes are used to assess the efficacy of GA and iv) how implementation of GA in oncology settings is reported.

Methods

We searched six electronic databases: PsycINFO, MEDLINE, Embase, CINAHL, The Cochrane Library and Web of Science using keywords and MeSH terms. Eligible reviews included systematic reviews with or without meta-analyses that i) described the use or value of GA in cancer settings or ii) information related to implementation of GA in cancer settings. Two reviewers reviewed articles for eligibility; data was extracted, and quality appraisal was conducted. The review was registered with PROSPERO:CRD42022338842.

Results

Of the 3,494 titles and abstracts screened, 128 full-text articles were reviewed and 35 reviews were selected for the umbrella review. A GA varied from interviews, self-administered assessments, medical assessments to chart reviews. Most systematic reviews reported that GA were performed prior to treatment by a range of health professionals (oncologists, cancer nurses and geriatricians) or patient self-report. Common patient-related outcomes included treatment toxicity, mortality, peri-operative complications. Treatment-related outcomes included modification to treatment plans, generally to a less intensive treatment and treatment completion. Service-related outcomes such as health care utilisation and length of stay were not commonly reported in reviews. Finally few reviews reported use of frameworks to guide GA implementation. 

Conclusion

Implementation of GA as part of standard care in Australian cancer services requires clearly defined outcomes and care pathways.