Communication About Fall Risk in Community Oncology Practice: The Role of Geriatric Assessment

被引:4
|
作者
Jensen-Battaglia, Marielle [1 ,2 ]
Lei, Lianlian [3 ]
Xu, Huiwen [4 ,5 ]
Loh, Kah Poh [2 ]
Wells, Megan [2 ]
Tylock, Rachael [2 ]
Ramsdale, Erika [2 ]
Kleckner, Amber S. [6 ]
Mustian, Karen M. [2 ]
Dunne, Richard F. [2 ]
Kehoe, Lee [2 ]
Bearden, James, III [7 ]
Burnette, Brian L. [8 ]
Whitehead, Mary [9 ]
Mohile, Supriya G. [2 ]
Wildes, Tanya M. [10 ]
机构
[1] Univ Rochester, Dept Publ Hlth Sci, Sch Med & Dent, 265 Crittenden Blvd, Rochester, NY 14642 USA
[2] Univ Rochester, James P Wilmot Canc Inst, Med Ctr, Rochester, NY 14642 USA
[3] Univ Michigan, Ann Arbor, MI 48109 USA
[4] Univ Texas Med Branch, Dept Prevent Med & Populat Hlth, Galveston, TX 77555 USA
[5] Univ Texas Med Branch, Sealy Ctr Aging, Galveston, TX 77555 USA
[6] Univ Maryland, Sch Nursing, Dept Pain & Translat Symptom Sci, Baltimore, MD 21201 USA
[7] Upstate Carolina NCORP, Spartanburg, SC USA
[8] NCORP, Canc Res Wisconsin & Northern Michigan CROWN, Green Bay, WI USA
[9] Univ Rochester, SCOREboard Advisory Grp, Med Ctr, Rochester, NY 14642 USA
[10] Canc & Aging Res Grp, St Louis, MO USA
关键词
AGED GREATER-THAN-OR-EQUAL-TO-65 YEARS; KARNOFSKY PERFORMANCE STATUS; ELDERLY CANCER-PATIENTS; OLDER-ADULTS; PHYSICAL PERFORMANCE; UNITED-STATES; DECISION-MAKING; CARE; RECOMMENDATIONS; IMPLEMENTATION;
D O I
10.1200/OP.22.00173
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PURPOSE Falls are a modifiable source of morbidity for older adults with cancer, yet are underassessed in oncology practice. In this secondary analysis of a nationwide cluster-randomized controlled trial, we examined characteristics associated with patient-oncologist conversations about falls, and whether oncologist knowledge of geriatric assessment (GA) resulted in more conversations. METHODS Eligible patients (ClinicalTrials.gov identifier: NCT02107443) were age >= 70 years, had stage III/IV solid tumor or lymphoma, were being treated with noncurative treatment intent, and >= 1 GA domain impairment. Patients in both arms underwent GA. At practices randomly assigned to the intervention arm, oncologists were provided a GA summary with management recommendations. In both arms, patients had one clinical encounter audio-recorded, transcribed, and coded to categorize whether a conversation about falls occurred. Generalized linear mixed models adjusted for arm, practice site, and other important covariates were used to generate proportions and odds ratios (ORs) from the full sample. RESULTS Of 541 patients (intervention N = 293 and usual care N = 248, mean age: 77 years, standard deviation: 5.3), 528 had evaluable audio recordings. More patients had conversations about falls in the intervention versus usual care arm (61.3% v 10.3%, P,.001). Controlling for the intervention and practice site, history of falls (OR, 2.1; 95% CI, 1.3 to 3.6; P = .005) and impaired physical performance (OR, 4.7; 95% CI, 1.7 to 12.8; P = .002) were significantly associated with patient-oncologist conversations about falls. CONCLUSION GA intervention increased conversations about falls. History of falls and impaired physical performance were associated with patient-oncologist conversations about falls in community oncology practice.
引用
收藏
页码:720 / +
页数:12
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