Using a geriatric oncology assessment to link with services (GOAL).

Journal Article

OBJECTIVE: Geriatric screening tools assess functional limitations and inform clinical decision-making for older adults with cancer. Our objective was to evaluate the feasibility and effectiveness of a screener in community-based oncology clinics. MATERIALS AND METHODS: Eligible patients were from two rural, underserved community-based cancer clinics; within 12 months of a cancer diagnosis (breast, lung, colorectal, pancreas, esophageal); aged ≥60 years; and not exclusively pursuing palliative care. We used a previously validated tool that was embedded in the electronic health record (EHR). Patient-reported responses identified memory impairment, depressive symptoms, deficits in activities of daily living, poor nutrition, and polypharmacy. At the discretion of the oncologist, responses prompted service referrals. From the EHR, we extracted information about referrals and completion of planned therapy. We present descriptive statistics. RESULTS: Enrolled patients (n = 44) had a mean age of 71.5 years (SD = 6.9). Most were non-white (61%), women (66%), with government-sponsored health insurance (80%). The most commonly identified geriatric syndromes: polypharmacy (89%), reduced quality of life (39%), and poor nutrition (39%). The screener triggered a referral in 98% of patients. Generated referrals were for depressive symptoms (52% needed, 39% received), nutrition (43% needed, 37% received), and polypharmacy (89% needed, 26% received). Patients were referred to social work (56%), nutrition (44%), and pharmacy (25%). Many patients completed planned radiation therapy (100%), surgery (70%), and chemotherapy (60%). CONCLUSIONS: Use of an EHR-embedded brief geriatric oncology assessment in rural oncology clinics identified geriatric syndromes that would benefit from provision of services in nearly all enrolled patients. TRIAL REGISTRATION: Identifier: NCT02906592.

Full Text

Duke Authors

Cited Authors

  • Zullig, LL; Kimmick, G; Smith, V; Little, K; Bosworth, HB; Gonzales, S; Oakes, MM; Shelby, RA; Owen, L; Altomare, IP

Published Date

  • January 2019

Published In

Volume / Issue

  • 10 / 1

Start / End Page

  • 164 - 168

PubMed ID

  • 29958815

Pubmed Central ID

  • 29958815

Electronic International Standard Serial Number (EISSN)

  • 1879-4076

Digital Object Identifier (DOI)

  • 10.1016/j.jgo.2018.06.004


  • eng

Conference Location

  • Netherlands