Communication With Older Patients With Cancer Using Geriatric Assessment: A Cluster-Randomized Clinical Trial From...

Area of Science:

• Geriatric oncology
• Patient-centered care
• Clinical communication

Background:

• Older cancer patients and caregivers often worry about treatment effects on aging domains like function and cognition.
• Quality conversations about aging-related concerns can improve patient outcomes.
• Geriatric assessment (GA) identifies aging-related conditions linked to poor outcomes in older cancer patients.

Purpose of the Study:

• To evaluate if providing oncologists with a GA summary and recommendations improves communication about aging-related concerns.

Main Methods:

• A cluster-randomized trial involving 541 older adults (≥70 years) with advanced cancer and their caregivers across 31 community oncology practices.
• Intervention group received tailored GA summaries and recommendations; usual care group received only alerts for depression or cognitive impairment.
• Primary outcome: patient satisfaction with communication about aging-related concerns; secondary outcomes: number of concerns discussed, quality of life, caregiver satisfaction.

Main Results:

• Patients in the intervention group reported higher satisfaction with communication about aging-related concerns post-visit and at 6 months (P=.04).
• Significantly more aging-related conversations occurred in the intervention group (P<.001).
• Caregivers in the intervention group also showed higher satisfaction with communication (P=.03), though quality of life did not differ.

Conclusions:

• Integrating GA into oncology visits for older adults with advanced cancer enhances patient-centered and caregiver-centered communication regarding aging concerns.
• GA summaries and recommendations can be a valuable tool for improving discussions on aging-related issues in cancer care.