PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.
This PCORI-funded implementation project is making the geriatric assessment, or GA, and its summary report on patients’ age-related problems part of routine care for older patients who are considering chemotherapy at community cancer clinics.
|More than two-thirds of new cancers occur in older adults. Problems related to age, such as issues with movement or memory loss, can affect how older adults respond to cancer treatment. In 2018, the American Society of Clinical Oncology issued guidelines that recommend using GAs to inform care for older adults with cancer who are considering chemotherapy. However, few community cancer clinics routinely use GAs with older patients.|
What is the goal of this implementation project?
Knowing about age-related problems can help doctors, patients, and caregivers make decisions about cancer care. One way to learn about these problems is through a GA, which includes surveys and other tests. A PCORI-funded research study found that patients and caregivers who had a GA plus a summary report were more satisfied with communication about age-related concerns during cancer treatment. Patients who received the report discussed more age-related problems with their doctors than patients who had a GA alone.
This project is making the GA and summary report part of standard care at community cancer clinics to improve the quality of care for older adults with cancer.
What will this project do?
The project team is putting the GA and summary report in place at eight clinics in four states.
The project team is adapting the GA to reduce the number of tests patients take. Doing so makes it easier for clinics to make the GA part of routine care. The team is also creating a website to support use of the summary report. Clinic staff can enter patients’ GA scores into the website. Then the website produces the summary report, which includes the results of the GA and guidance for care.
To put the GA and summary report in place, the project team is:
- Working with teams at each site to use the GA and report in practice. Teams include a clinical champion to promote the GA and report, a nurse or medical assistant, and an administrative staff member, such as a clinic manager.
- Holding online trainings for clinical teams on how to administer the GA, discuss the results with patients and caregivers using the reports, and provide recommended referrals.
- Working with the Association of Community Cancer Centers, or ACCC, to provide practices with support and monthly feedback on their use of the GA and summary report and ways to improve care.
The project team is also helping sites develop different ways for patients to access and complete the GA. For example, patients can use email or the patient portal. Also, patients can complete the GA at home or in the doctor’s office.
What is the expected impact of this project?
The project is demonstrating what’s required to put the GA and summary report in place at community cancer clinics. The ACCC will continue to offer support and feedback to its member clinics after the project ends.
More than 6,000 patients with cancer and their caregivers and 700 clinicians will receive the GA and report. The project evaluation will confirm that the GA and report is working as intended to improve communication and care for older adults with cancer.
More about this implementation project:
Stakeholders Involved in This Project
To document implementation:
To assess healthcare and health outcomes:
Initial PCORI-Funded Research Study
This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Do Reports That Capture the Age-Related Problems of Older Patients with Cancer Improve Doctor-Patient Conversations? -- The COACH Study