Abstract
Purpose
Comprehensive Geriatric Assessment (CGA) can identify health problems in older persons.
In addition, CGA includes intervention towards the identified problems. With follow
up, more problems may be identified and the interventions can be adjusted. We wanted
to compare CGA with or without tailored follow-up in a randomised design.
Patients and Methods
Patients 70+ years referred for oncology treatment with four primary tumour sites.
Participants were randomised 1:1 to either control group with no follow-up or intervention
group with a tailored follow-up by a multidisciplinary team. Primary outcome was adherence
to cancer treatment. Secondary outcomes were daily life activities, physical performance
and hospitalisation.
Results
In total, 363 participants were randomised. After randomisation only 301 were planned
to receive specific cancer treatment. Median age was 75 years. Among the 301 participants,
52% of control group vs. 61% of intervention group completed treatment. Risk Rate
(RR): 1.16 (95% Confidence Interval (CI): 0.95–1.42), p = .14. The impact varied between the included tumour-sites, p < .01. We found no difference in 90 days physical performance or daily life activities
between groups. During the study period, 55% of controls vs. 47% in the intervention
group were admitted to hospital, RR: 0.86 (95%CI: 0.69–1.07), p = .19.
Conclusion
In frail and vulnerable patients with cancer, a tailored follow-up on CGA showed no
differences in ability to complete initially planned cancer treatment. The impact
varied between the included tumour sites. We did not find any impact of tailored follow-up
on daily life activities, physical performance or hospitalisation.
Keywords
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Article info
Publication history
Published online: August 01, 2020
Accepted:
July 18,
2020
Received in revised form:
April 21,
2020
Received:
October 25,
2019
Identification
Copyright
© 2020 Elsevier Ltd. All rights reserved.
