e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

Implementing a Geriatric Oncology Model of Care for Lung Cancer patients (#303)

Shalini K Vinod 1 2 , Angela Khoo 3 , Thomas Tran 1 , Abhijit Pal 1 4 , Megan Berry 1 2 , Jana Borovskis 5 , Elise Tcharkhedian 5 , Millina Savann 6 , Katherine Bell 7 , Victoria Bray 1 8
  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. Northern Clinical School, University of Sydney, Camperdown, NSW, Australia
  5. Physiotherapy Department, Liverpool Hospital, Liverpool, NSW, Australia
  6. Occupational Therapy Department, Liverpool Hospital, Liverpool, NSW, Australia
  7. Dietetics Department, Liverpool Hospital, Liverpool, NSW, Australia
  8. School of Medicine, Western Sydney University, Penrith, NSW, Australia

Aims

Geriatric screening and assessment for older patients with lung cancer is recommended by many cancer societies. We aimed to implement a geriatric oncology model of care in this patient population.

Methods

Key stakeholders (oncologists, geriatrician, allied health) were invited to assess interest and feasibility of developing a geriatric oncology model of care. The G8 (Geriatric 8) health status screening tool was the chosen screening instrument. It was agreed to screen all lung cancer patients aged 70+ years for whom intravenous systemic therapy was recommended and to consider screening patients with recommendations for definitive radiotherapy or oral systemic therapy with a clinical frailty score ≥5. Information technology support was sought to build an electronic form of G8 within MOSAIQ. Patients scoring ≤14 on G8 had an automated referral generated for the Multidisciplinary Aged Care Cancer Service (MACCS), a new clinic, where patients undergo a comprehensive geriatric assessment (CGA) by a geriatrician and the allied health team. These patients are then discussed at a regular Geriatric Oncology Multidisciplinary Team (MDT) meeting.

Results

From 19/4/21 – 30/6/2021, 14 patients were eligible for screening, 12 of whom were screened with G8. An additional one patient scheduled for curative radiotherapy was also screened. Of the 13 patients screened, 8 met eligibility for referral to MACCS based on their G8 scores, five underwent CGA, 2 failed to attend and one patient died before their appointment. Of the 5 patients who underwent CGA, the recommended treatment plan was not altered, however multiple issues were identified that required further action by the oncology team or the GP including undiagnosed early dementia, risk of delirium, risk of falls and medication changes.

Conclusions

With stakeholder engagement and use of information technology to streamline processes, a geriatric oncology model of care was successfully implemented for older patients with lung cancer.