Implementation and evaluation of a remote geriatric assessment and intervention program in Brazil

Area of Science:

• Geriatric Oncology
• Telehealth
• Health-Related Quality of Life

Background:

• Older adults with cancer in Brazil face unique challenges.
• Access to specialized geriatric care can be limited in resource-constrained settings.
• Telehealth offers a potential solution to bridge these gaps.

Purpose of the Study:

• To assess the feasibility and acceptability of a remote geriatric assessment and implementation (GAIN) program for older cancer patients in Brazil.
• To evaluate the impact of the remote GAIN program on health-related quality of life (HR-QOL) outcomes.
• To explore the program's potential in improving patient-reported outcomes in low-resource environments.

Main Methods:

• A longitudinal study involving older adults (65+ years) with solid tumors initiating chemotherapy.
• Remote geriatric assessment conducted via telehealth.
• Assessment of feasibility, patient acceptability, and changes in HR-QOL, mood, and function from baseline to 3 months.
• Linear mixed model analysis adjusted for demographic and disease-related factors.

Main Results:

• High feasibility (92% adherence) and acceptability were observed in 56 patients.
• Significant improvements were noted in HR-QOL (FACT-G), depression (Geriatric Depression Scale), and daily living activities.
• Most patients diagnosed with advanced gastrointestinal and gynecological cancers benefited from the remote interventions.

Conclusions:

• Remote GAIN is a feasible and acceptable model for older cancer patients in Brazil.
• The program demonstrates significant improvements in patient-reported HR-QOL outcomes.
• This telehealth approach can aid in early toxicity detection and enhance patient outcomes in underserved areas.