Communication about geriatric assessment domains in advanced cancer settings: "Missed opportunities". Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Lowenstein, Lisa M.; Volk, Robert J.; Street, Richard; Flannery, Marie; Magnuson, Allison; Epstein, Ronald; Mohile, Supriya G.
• Is Part Of: Journal of geriatric oncology. Volume 10:Issue 1(2019)
• Page Start: 68
• Page End: 73
• Publication Date: 2019-01
• Subjects: Oncology -- Qualitative -- Provider-patient communication -- Geriatric assessment; Geriatric oncology -- Periodicals; Neoplasms -- Periodicals; Aged -- Periodicals; Geriatric oncology; Electronic journals; Periodicals; 618.976994005
• DOI: 10.1016/j.jgo.2018.05.014
• Languages: English
• ISSNs: 1879-4068

Abstract

Abstract: Objectives: Older patients with advanced cancer often have age-related health issues (e.g., memory impairment) that influence their cancer treatment decisions. Communication about these age-related concerns can potentially lead to further assessment and subsequent clinical interventions to improve treatment decision-making and patients' quality of life. Yet, little is known about the communication of age-related concerns between oncologists, patients, and caregivers. Materials and Methods: This study is a secondary analysis of data from the Values and Options in Cancer Care (VOICE) study. Audio-recorded and transcribed outpatient clinical oncology encounters with 37 patients with advanced cancer ≥60 years of age were content-analyzed. Two trained coders used a structured coding scheme based on pre-specified geriatric assessment (GA) domains to examine the transcripts for the frequency and quality of communication about age-related concerns. Atlas.ti version 6 was used for all analyses. Results: The median age of the patients was 66 years (range = 60–90 years); patients were mostly female (26/37), married (22/37), and White (36/37). Out of 37 audio-recorded visits, 31 had at least one mention of an age-related concern with a total of 70 mentions. Oncologists initiated communication about age-related concerns half of the time (53%). When age-related concerns were mentioned, half of the time (50%) the oncologist did not implement further evidence-based interventions to address the age-related concern (e.g., conduct a cognitive screen for a memory concern). Conclusion: Interventions are needed to improve the frequency and quality of the communication about age-related concerns to improve the care of older adults with cancer.