None listed
Conditions
Brief summary
The GAIN-Woll study aims to improve cancer care for older people by testing whether a simple geriatric assessment can better support treatment planning for patients aged 70 years and over with advanced cancer. Who is it for? You may be eligible for this study if you are aged 70 years or older, have advanced cancer where further treatment is being considered, be receiving treatment at Wollongong Hospital or the Illawarra Cancer Care Centre, and be able to communicate in English. Study details Participants who join the study will attend an appointment with a geriatrician at Wollongong Hospital within three weeks of enrolment. During this visit, they will complete a Practical Geriatric Assessment, which takes around 10 to 25 minutes and looks at areas such as physical function, nutrition, medical conditions, and daily activities. All participants in the study receive the assessment; there is no randomisation. Based on the assessment results, the geriatrician will develop a personalised management plan. This may include referrals to allied health services and discussions about future care planning. A short report summarising the assessment results is provided to the participant’s cancer doctor to help inform treatment decisions. Participants will be asked to complete the acceptability questionnaire at the end of the study, health conditions and compliance will be assessed from medical records. It is hoped that this research will show whether using this assessment improves cancer care planning and support for older adults with advanced cancer.
Interventions
The intervention in the GAIN-Woll study involves a new model of care at Wollongong Hospital with the use of the Practical Geriatric Assessment (PGA) to develop tailored management plans for enrolled patients. The PGA has been used elsewhere and was developed by the American Society of Clinical Oncology. Consenting patients will be referred for a one hour appointment with a geriatrician at Wollongong Hospital, scheduled within three weeks of enrolment. During this appointment, the patient complet
The intervention in the GAIN-Woll study involves a new model of care at Wollongong Hospital with the use of the Practical Geriatric Assessment (PGA) to develop tailored management plans for enrolled patients. The PGA has been used elsewhere and was developed by the American Society of Clinical Oncology. Consenting patients will be referred for a one hour appointment with a geriatrician at Wollongong Hospital, scheduled within three weeks of enrolment. During this appointment, the patient completes the self-directed component of the PGA, and the geriatrician completes the remaining components with the patient. Following the assessment, the geriatrician reviews the results using the PGA action chart and their clinical judgement to develop a personalised management plan which is discussed with the patient during the initial appointment. These management plans include several key interventions, specifically: streamlined allied health referrals and discussions around advanced care planning. Crucially, a standardised brief report is provided to the treating medical oncologist to assist with their cancer treatment decision-making. This report details the patient's Deficit Accumulation Index score, a breakdown of assessed geriatric domains (e.g., physical function, nutrition, comorbidity) and relevant plans for identified impairments, along with the CARG Chemo-Toxicity calculator score. Compliance with management plans will be assessed by reviewing patient medical records 12 weeks post-commencement of cancer treatment.
Sponsors
Illawarra Shoalhaven Local Health District
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patient: 1. Age 70 years or older. 2. Advanced cancer where non-curative intent treatment is being considered. 3. Advanced cancer has either recently been diagnosed, or has recently progressed on treatment and another line of systemic therapy is being considered. 4. Treatment is planned at Wollongong Hospital / Illawarra Cancer Care Centre. 5. Proficiency in English language. Oncologist: 1. A treating oncologist working at Wollongong Hospital.
Exclusion criteria
Patient: 1. Participant is an inpatient at time of treatment consideration and unable to attend the outpatient geriatrics clinic. 2. Participant has expressed wishes to cease any anti-cancer systemic therapy. 3. Life expectancy is less than 3 months. 4. Severe dementia. Oncologist: 1. Unavailable to see patients during the study period.
Outcome results
None listed