Geriatric Assessment-Guided Care Processes for Older Adults: A Delphi Consensus of Geriatric Oncology Experts
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Open Access
- 10 September 2015
- journal article
- review article
- Published by Harborside Press, LLC in Journal of the National Comprehensive Cancer Network
- Vol. 13 (9), 1120-1130
- https://doi.org/10.6004/jnccn.2015.0137
Abstract
Background: Structured care processes that provide a framework for how oncologists can incorporate geriatric assessment (GA) into clinical practice could improve outcomes for vulnerable older adults with cancer, a growing population at high risk of toxicity from cancer treatment. We sought to obtain consensus from an expert panel on the use of GA in clinical practice and to develop algorithms of GA-guided care processes. Methods: The Delphi technique, a well-recognized structured and reiterative process to reach consensus, was used. Participants were geriatric oncology experts who attended NIH-funded U13 or Cancer and Aging Research Group conferences. Consensus was defined as an interquartile range of 2 or more units, or 66.7% or greater, selecting a utility/helpfulness rating of 7 or greater on a 10-point Likert scale. For nominal data, consensus was defined as agreement among 66.7% or more of the group. Results: From 33 invited, 30 participants completed all 3 rounds. Most experts (75%) used GA in clinical care, and the remainder were involved in geriatric oncology research. The panel met consensus that “all patients aged 75 years or older and those who are younger with age-related health concerns” should undergo GA and that all domains (function, physical performance, comorbidity/polypharmacy, cognition, nutrition, psychological status, and social support) should be included. Consensus was met for how GA could guide nononcologic interventions and cancer treatment decisions. Algorithms for GA-guided care processes were developed. Conclusions: This Delphi investigation of geriatric oncology experts demonstrated that GA should be performed for older patients with cancer to guide care processes.Keywords
This publication has 43 references indexed in Scilit:
- Defining consensus: A systematic review recommends methodologic criteria for reporting of Delphi studiesJournal of Clinical Epidemiology, 2014
- Performance of Two Geriatric Screening Tools in Older Patients With CancerJournal of Clinical Oncology, 2014
- Evaluation of the Groningen Frailty Indicator and the G8 questionnaire as screening tools for frailty in older patients with cancerJournal of Geriatric Oncology, 2012
- Use of Geriatric Assessment for Older Adults in the Oncology Setting: A Systematic ReviewJNCI Journal of the National Cancer Institute, 2012
- Research Priorities in Geriatric Oncology: Addressing the Needs of an Aging PopulationJournal of the National Comprehensive Cancer Network, 2012
- Predicting Chemotherapy Toxicity in Older Adults With Cancer: A Prospective Multicenter StudyJournal of Clinical Oncology, 2011
- Chemotherapy options in elderly and frail patients with metastatic colorectal cancer (MRC FOCUS2): an open-label, randomised factorial trialThe Lancet, 2011
- Implementing a Geriatric Assessment in Cooperative Group Clinical Cancer Trials: CALGB 360401Journal of Clinical Oncology, 2011
- Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics supportJournal of Biomedical Informatics, 2008
- ADVANCING GERIATRIC NURSING PRACTICE; A Specialized Home Care Intervention Improves Survival Among Older Post‐Surgical Cancer PatientsJournal of the American Geriatrics Society, 2000