Communication About Fall Risk in Community Oncology Practice: The Role of Geriatric Assessment

Area of Science:

• Geriatric Oncology
• Patient Safety
• Clinical Communication

Background:

• Falls represent a significant, yet often overlooked, cause of morbidity in older adults with cancer.
• Effective assessment and management of fall risk are crucial in oncology settings.
• Current oncology practice often underassesses fall risks in elderly cancer patients.

Purpose of the Study:

• To examine factors associated with patient-oncologist discussions about falls in older cancer patients.
• To determine if providing oncologists with geriatric assessment (GA) summaries increases these conversations.
• To identify patient characteristics linked to fall-related discussions.

Main Methods:

• Secondary analysis of a nationwide cluster-randomized controlled trial (NCT02107443).
• Included patients aged ≥70 with advanced solid tumors/lymphoma receiving noncurative treatment and at least one GA domain impairment.
• Audio recordings of clinical encounters were coded to identify fall conversations; generalized linear mixed models were used for analysis.

Main Results:

• Conversations about falls occurred in 61.3% of patients in the intervention arm versus 10.3% in the usual care arm (P < .001).
• A history of falls (OR, 2.1) and impaired physical performance (OR, 4.7) were significantly associated with increased fall conversations.
• The GA intervention demonstrated a substantial increase in patient-oncologist dialogue regarding falls.

Conclusions:

• Geriatric assessment (GA) intervention effectively increases patient-oncologist conversations about falls in community oncology.
• Identifying patients with a history of falls or impaired physical performance can help target these crucial discussions.
• Improving communication about falls is vital for enhancing the safety and quality of life for older adults with cancer.