title: Implementation of geriatric assessment-based recommendations in older patients with cancer: A multicentre prospective study.
abstract: OBJECTIVE
  The main objective of this study was to describe geriatric recommendations based on a geriatric assessment (GA) and to evaluate the implementation of these recommendations.
  
  
  METHODS
  A two-step approach of screening followed by a GA was implemented in nine hospitals in Belgium. Patients ≥ 70 years were included at diagnosis or at disease progression/relapse. Concrete geriatric recommendations were systematically documented and reported to the treating physicians and consisted of referrals to professional health care workers. Patient charts were reviewed after one month to verify which geriatric recommendations have been performed.
  
  
  RESULTS
  From August 2011 to July 2012, 1550 patients were included for analysis. The median age was 77 (range: 70-97) and 57.0% were female. A solid tumour was diagnosed in 91.4% and a haematological malignancy in 8.6%. Geriatric screening with the G8 identified 63.6% of the patients for GA (n=986). A median of two geriatric recommendations (range: 1-6) were given for 76.2% (95%CI: 73.4-78.8) of the evaluable patients (n=710). A median of one geriatric recommendation (range: 1-5) was performed in 52.1% (95%CI: 48.4-55.8) of the evaluable patients (n=689). In general, 460 or 35.3% (95%CI: 32.8-38.0) of all the geriatric recommendations were performed. Geriatric recommendations most frequently consisted of referrals to the dietician (60.4%), social worker (40.3%), and psychologist (28.9%).
  
  
  CONCLUSIONS
  This implementation study provides insight into GA-based recommendations/interventions in daily oncology practice. Geriatric recommendations were given in about three-fourths of patients. About one-third of all geriatric recommendations were performed in approximately half of these patients.
authors: Department of Medical Oncology, ZNA Middelheim, Antwerp, Belgium.
authors: Abdelbari
authors: A
authors: Baitar
authors: Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
authors: Cindy
authors: C
authors: Kenis
authors: Department of Medical Oncology, Cliniques Universitaires Saint-Luc, UCL, Brussels, Belgium.
authors: Ramona
authors: R
authors: Moor
authors: Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors: Lore
authors: L
authors: Decoster
authors: Department of Medical Oncology, University Hospital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium.
authors: Sylvie
authors: S
authors: Luce
authors: Department of Hematology, Institut Jules Bordet (ULB), Brussels, Belgium.
authors: Dominique
authors: D
authors: Bron
authors: Department of Medical Oncology, ZNA Stuivenberg, Antwerp, Belgium.
authors: Ruud
authors: R
authors: Van Rijswijk
authors: Department of Medical Oncology, Iridium Cancer Network Antwerp, St. Augustinus, Wilrijk, Belgium.
authors: Marika
authors: M
authors: Rasschaert
authors: Department of Medical Oncology, Iridium Cancer Network Antwerp, AZ Klina, Brasschaat, Belgium.
authors: Christine
authors: C
authors: Langenaeken
authors: Department of Medical Oncology, Centre Hospitalier Universitaire Sart Tilman, Liege, Belgium.
authors: Guy
authors: G
authors: Jerusalem
authors: Beernem, Belgium.
authors: Jean-Pierre
authors: JP
authors: Lobelle
authors: Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.
authors: Johan
authors: J
authors: Flamaing
authors: Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Health Services and Nursing Research, KU Leuven, Leuven, Belgium.
authors: Koen
authors: K
authors: Milisen
authors: Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium. Electronic address: hans.wildiers@uzleuven.be.
authors: Hans
authors: H
authors: Wildiers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000453:epidemiology* / Q000628:therapy; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D015996:Survival Rate / Q000639:trends
keywords: Cancer; Geriatric assessment; Geriatric recommendations; Older persons