Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Implementation and evaluation of a geriatric-oncology model of care for older patients with lung cancer (#243)

Shalini K Vinod 1 2 , Angela Khoo 3 , Megan Berry 1 2 , Katherine Bell 4 , Elhassan Ahmed 5 , Josephine Campisi 6 , Cara Gollon 6 , Abhijit Pal 1 , Sau Kwan Seto 6 , Elise Tcharkhedian 5 , Thomas Tran 1 , Victoria Bray 1 7
  1. Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW, Australia
  2. South Western Sydney Clinical School, University of NSW, Liverpool, NSW, Australia
  3. Department of Geriatrics, Liverpool Hospital, Liverpool, NSW, Australia
  4. Dietetics Department, Liverpool Hospital, Liverpool, NSW, Australia
  5. Physiotherapy Department, Liverpool Hospital, Liverpool, NSW, Australia
  6. Occupational Therapy Department, Liverpool Hospital, Liverpool, NSW, Australia
  7. School of Medicine, Western Sydney University, Penrith, NSW, Australia

Introduction

35-44% of all lung cancers occur in patients aged 75+ years. Geriatric screening and assessment is recommended in older patients but only 17-29% of clinicians do this. We aimed to implement and evaluate a geriatric oncology model of care (GOMOC) for older patients with lung cancer.

 

Methods

Key stakeholders were brought together to design a GOMOC within existing resources. The geriatric 8 (G8) screening tool was used to screen patients with a new diagnosis of lung cancer aged 70+ years guided by traffic light criteria to select patients for screening. G8 score <15 prompted referral for a comprehensive geriatric assessment with a geriatrician and allied health at a fortnightly clinic. A virtual geriatric oncology multidisciplinary team meeting (MDM) was held following the clinic to discuss management with oncologists.

 

Results

Over 12 months, 73 patients were eligible for screening and 62 (85%) were screened. Seven ineligible patients were screened (3 mesothelioma, 4 recurrent lung cancer). 74% (51/69) had a G8 score <15 and were referred but only 59% (30/51) were assessed in clinic. The geriatrician diagnosed new cognitive issues in 30% (7) patients and recommended medication changes in 83% (25) patients. Physiotherapy recommendations were made in 77% (20/26 seen) and occupational therapy recommendations in 65% (17/26 seen). 100% (8/8) and 88% (7/8) stated that this was an acceptable and feasible model of care respectively. Barriers to screening were lack of time in clinic with multiple competing priorities. Facilitator to screening was a simple screening tool incorporated into electronic medical records. Strengths of GOMOC included the multidisciplinary assessment, proactive care and MDM discussion. Weaknesses included the lack of clinic capacity and fortnightly frequency.

Conclusion

An acceptable GOMOC was implemented for older patients with lung cancer. However further modification is needed to improve the number of eligible patients undergoing comprehensive geriatric assessment.