Patients with a higher degree of frailty and those exposed to a geriatric assessment (GA) had more conversations and better-quality conversations about aging-related concerns with their oncologists, according to a recent study.
“Oncologists’ acknowledgment of an aging-related concern provides a communication opportunity for future discussions and an open forum in which patient-oncologist rapport and trust can be built; this can yield a greater likelihood that the aging- related concern will be appropriately addressed,” study researchers wrote.
The study was a secondary analysis of a nationwide trial of patients aged older than 70 with incurable cancer and impairment of one or more GA domains. Practice sites in the study were randomly assigned to either the GA intervention or usual care.
Frailty was categorized as robust (27%), prefrail (42%), or frail (31%). Among patients assigned to usual care, frail patients engaged in more aging-related conversations compared with those considered to be robust (adjusted mean difference 1.73). Frail patients also had higher quality conversations and more discussions about evidence-based recommendations.
“This finding indicates that frail patients and their oncologists were more likely to have aging- related conversations regarding areas such as functional status and/or nutritional status, and it was more likely for oncologists to adequately ad-dress these concerns with a referral to a physical therapist and/or nutritionist,” the researchers wrote.
There was no significant difference in the number of aging-related conversations between prefrail and robust patients.
Among patients assigned to the GA arm, frail patients also engaged in more aging related conversations compared with robust patients (difference: 2.49). These frail patients also had higher quality conversations and more discussion about evidence-based recommendations.
The GA intervention did significantly improve the number and quality of conversations in all patient frailty groups.
“Because of the influence that frailty can have on treatment decisions and prognosis, oncologists should have more frequent discussions about aging-related concerns with prefrail and frail older patients with advanced cancer; such discussions would likely lead to better clinical out-comes,” the researchers wrote. “The GA can aid oncologists in identifying prefrail individuals who might benefit from these aging- related conversations.”
