- Theresa Wiseman (London, United Kingdom)
Specific considerations for older adults undergoing anti-cancer therapies
- Michelle Hannan (Waterford, Ireland)
Position statement paper related to the care for older patients with cancer between SIOG/ EONS/ CANO
- Martine Puts (Toronto, Canada)
Supportive and palliative care in geriatric oncology
- Kristen Haase (Saskatoon, Canada)
CN14 - The utility of a brief clinical frailty scale (CFS) in predicting prognosis and discharge destination in oncology inpatients
- Jenny Welford (Newcastle-upon-Tyne, United Kingdom)
Abstract
Background
Frailty is common in patients with cancer, and can predict outcomes and responses to treatment. Both cancer related symptoms and the impact of treatment can lead to increasing frailty in this population. The Rockwood CFS is a rapid tool which was originally designed in the 65+ population to assess underlying physiology and chances of functional improvement when older patients are admitted to hospital. When cancer patients are admitted to hospital it can be difficult to assess their fitness, using standard tools such as performance status. The utility of the CFS in cancer inpatients and whether it can be used in patients <65 years is unknown.
Methods
Clinical Frailty Score was measured as in Rockwood et al (PMID:
Results
237 patients had an assessment from 01/01/2019 to 01/04/2020. 151 patients have died, with a median follow-up of 190 days. Age ranged from 21 to 92 (median 67); 100 patients were <65. CFS significantly predicted survival (P<0.0001) as outlined in the table and the association was maintained in the group <65. Patients with a CFS score <5 had an 86% chance of getting home with appropriate support compared to 58% if CFS >6 (Odds ratio 4.6 (95% CI 2.3 to 9.3): P<0.0001).
CFS score Number in category Median Survival HR (reference group CFS 4 (95%CI in brackets)) 2 2 Not Reached Not calculated 3 15 198 days 0.85 (0.39 to 1.85) 4 45 202 days 1 5 41 109 days 1.63 (0.90 to 2.95) 6 75 71 days 2.13 (1.36 to 3.40) 7 27 75 days 1.85 (1.0 to 3.37) 8 21 10 days 5.74 (2.4 to 13.8)
Conclusions
Routine assessment of CFS can be easily implemented onto oncology inpatient wards, with high levels of frailty seen. High CFS was associated with poor prognosis, and this included the <65 age group. CFS may help in discussions with patients and families as to prognosis, treatment escalation and planning for discharge.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
CN5 - Video consultations with older patients in the oncology nursing outpatient clinic
- Karin B. Dieperink (Odense C, Denmark)
Abstract
Background
Weekly 10-15 older patients with intestinal cancer are physical assessed by a nurse in order to determine whether the patient is able to receive the second chemotherapy. Many patients are vulnerable and have long geographical distances to the hospital and physically demanding transport time. Family are challenged to be present due to work, other family obligations and geographical distances. The purpose was to investigate how patients, family and nurses experience video consultations as a substitute for physical attendance, in order to understand if it is feasible to assess clinically via screen and to understand barriers and facilitators.
Methods
This design was a mixed methods study. Video consultations were implemented in the spring 2019. Patients who had participated in at least one video consultation were asked to fill out questionnaires with socio-economically data about time saved for transport and kilometers saved. Descriptive statistics was used. Qualitative data was collected by semi structured interviews with patients and family caregivers and one focus group interviews with oncology nurses. Analysis of qualitative data was according to content analysis.
Results
85/119 patients (71%) responded to the questionnaire. Mean age 66 years (SD 7.8) Most patients were male 59(69.4%). In average patients saved to drive 153 kilometers, range 2-450 km, driving in their own car or public transport, and in average 1-2 hours saved for transport. 15 patients and family caregivers participated in the interviews and 6 nurses in the focus group. Patients experienced freedom and more energy prior to chemotherapy. The consultations took place in a quieter environment, which provided energy for the patient. Family caregivers found it easier to participate in video consultations than physical attendance. The nurses’ experienced a need to learn how to provide nursing by screen and the clinical assessment was challenged by technical problems.
Conclusions
Older cancer patients experienced freedom and felt more comfortable using video consultations, and family involvement increased. Socioeconomically, video consultation is a success but testing the patient's equipment, technical skills and nursing skills is important in order to make an optimal clinical assessment.
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Q&A live discussion
- Theresa Wiseman (London, United Kingdom)