Abstract
Introduction
Low physical function is associated with adverse outcomes in older adults with cancer,
but evidence on real-world, clinical management of low physical function in oncology
is lacking. We explored whether impairments in muscle strength and/or physical performance
triggered downstream management by clinicians, the types of recommended strategies,
and the reasons for not providing a referral/strategy for addressing such impairments
in older cancer survivors prior to treatment.
Materials and Methods
We conducted a retrospective, cross-sectional study of older adults who completed
a comprehensive geriatric assessment (CGA) prior to cancer treatment in a tertiary
cancer centre. Muscle strength and physical performance were assessed through grip
strength and the Short Physical Performance Battery (SPPB), respectively. Patients
who exhibited an impairment in grip strength and/or SPPB were classified as having
abnormal objective physical function. Downstream management strategies and clinicians'
reasons for not providing referrals were retrieved from clinical notes and an institutional
database.
Results
In total, 515 older adults (mean age: 80.7 years) were included. Low grip strength
and/or SPPB combined was observed in 66.4% (n = 342) of participants, of whom 54.1% (n = 185) received an acceptable intervention. However, 41.2% (n = 141) were not provided with a referral/strategy by clinicians to address such impairments
following CGA. No reasons were provided in clinical notes for not addressing impairments
in physical function for 100 participants (70.9%).
Discussion
Many older adults with cancer have impaired physical function prior to treatment.
However, we found that such impairments are not systematically addressed by clinicians,
and documentation was often suboptimal, identifying gaps in patient care that need
to be addressed.
Keywords
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Article info
Publication history
Published online: January 24, 2023
Accepted:
January 9,
2023
Received in revised form:
December 2,
2022
Received:
September 21,
2022
Identification
Copyright
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