The geriatricians’ perspectives on geriatric oncology in the Netherlands – results of a national survey

Hamaker, Marije E.; Jonker, J.M.; Maas, Huub; Schiphorst, A. H. W.; Portielje, Johanneke E.A.; Smorenburg, C.H.

doi:10.1016/j.eurger.2014.02.003

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…Furthermore, while there is general consensus that they can be beneficial, there is no clear guideline on when, how, and by whom they should be performed [12, 13]. The presented method of geriatric screening followed by full geriatric consultation and assessment for selected patients may be adequately time efficient.…”

Section: Discussionmentioning

confidence: 99%

“…The incorporation of a routine geriatric assessment in standard oncologic care for all elderly patients with cancer is currently hampered by the time- and resource-consuming nature of these assessments [ 12 , 13 ]. Furthermore, while there is general consensus that they can be beneficial, there is no clear guideline on when, how, and by whom they should be performed [ 12 , 13 ]. The presented method of geriatric screening followed by full geriatric consultation and assessment for selected patients may be adequately time efficient.…”

Section: Discussionmentioning

confidence: 99%

“…An important yield of the geriatric assessment was clarifying patient’s priorities and expectations concerning the proposed treatment options. It appears that this is mostly due to a greater amount of time available for the assessment and does not necessarily require expertise specific to the geriatrician [ 13 ]. In an age where the amount of time spent on staging and exploring disease characteristics is rapidly increasing, and more and more money is spent on increasingly sophisticated anti-cancer treatments, taking the time to sit down with a patient and explore what they want and whether or not they will be able to benefit from and tolerate cancer treatment should not be a matter of discussion [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although a myriad of publications have propagated its use, the actual implementation of geriatric assessments in clinical practice has thus far been limited [ 3 , 11 – 13 ]. In the Diakonessenhuis and Haga hospital, two large teaching hospitals in the Netherlands, geriatric assessments for patients with lung cancer have been implemented in the standard care for patients over 70 years of age since 2014.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of A Geriatric Assessment on Treatment Decisions for Patients with Lung Cancer

Schulkes

Souwer

Hamaker

et al. 2017

Lung

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BackgroundDecision-making for older patients with lung cancer can be complex and challenging. A geriatric assessment (GA) may be helpful and is increasingly being used since 2005 when SIOG advised to incorporate this in standard work-up for the elderly with cancer. Our aim was to evaluate the value of a geriatric assessment in decision-making for patients with lung cancer.MethodsBetween January 2014 and April 2016, data on patients with lung cancer from two teaching hospitals in the Netherlands were entered in a prospective database. Outcome of geriatric assessment, non-oncologic interventions, and suggested adaptations of oncologic treatment proposals were evaluated.Results83 patients (median age 79 years) were analyzed with a geriatric assessment, of which 59% were treated with a curative intent. Half of the patients were classified as ECOG PS 0 or 1. The majority of the patients (78%) suffered from geriatric impairments and 43% (n = 35) of the patients suffered from three or more geriatric impairments (out of eight analyzed domains). Nutritional status was most frequently impaired (52%). Previously undiagnosed impairments were identified in 58% of the patients, and non-oncologic interventions were advised for 43%. For 33% of patients, adaptations of the oncologic treatment were proposed. Patients with higher number of geriatric impairments more often were advised a reduced or less intensive treatment (p < 0.001).ConclusionA geriatric assessment uncovers previously unknown health impairments and provides important guidance for tailored treatment decisions in patients with lung cancer. More research on GA-stratified treatment decisions is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Effect of A Geriatric Assessment on Treatment Decisions for Patients with Lung Cancer

Schulkes

Souwer

Hamaker

et al. 2017

Lung

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“…Remarkably, these observational studies also showed oncologists implemented CGA recommendations to treatment plans in 92-100% of patients seen [ 12 , 14 ]. However, while the international oncology community acknowledges benefit from CGA, it is not yet a standard of care for complex geriatric oncology patients to undergo evaluation with CGA [ 10 , 15 ].…”

Section: An Approachable Targetmentioning

confidence: 99%

Is it time for comprehensive geriatric assessment to move beyond primary care? The case for targeting medical sub-specialty practice

Byerly

Harper

2017

Isr J Health Policy Res

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Comprehensive geriatric assessment (CGA) as a consultative service for older adults with complex medical and psychosocial challenges has existed for decades. However, studies have often showed inconsistent acceptance and implementation of geriatric recommendations by primary care providers (PCPs) raising doubts about the overall benefits of CGA in this setting. Press and colleagues investigated the patient- and provider-related factors that affect recommendation implementation, and like previous studies, they too found similarly low rates of implementation. In this commentary, we acknowledge the perennial challenges that exist to improving the acceptance of CGA in primary care practice, and we suggest an alternative target: medical sub-specialty practice. By highlighting three medical sub-specialty fields (oncology, nephrology, and cardiology), which have demonstrated that CGA can be incorporated into their respective clinical practices, we argue that CGA may prove to have greater impact in these settings than in primary care. We also propose initial research steps that could further delineate the trends, outcomes, and next steps for such consultations.

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Caring for older cancer patients: A scoping review

et al. 2020

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The geriatricians’ perspectives on geriatric oncology in the Netherlands – results of a national survey

Cited by 6 publications

References 16 publications

The Effect of A Geriatric Assessment on Treatment Decisions for Patients with Lung Cancer

The Effect of A Geriatric Assessment on Treatment Decisions for Patients with Lung Cancer

Is it time for comprehensive geriatric assessment to move beyond primary care? The case for targeting medical sub-specialty practice

Caring for older cancer patients: A scoping review

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