F-OGS, a new “Follow-up Onco-Geriatric Screening” tool during the follow-up of older patients undergoing oncological treatment. Pilot study of feasibility and acceptability

Abstract Background Falls in older Emergency Department (ED) patients may indicate underlying frailty. Geriatric follow-up might help improve outcomes in addition to managing the direct cause and consequence of the fall. We aimed to study whether fall characteristics and the result of geriatric screening in the ED are independently related to adverse outcomes in older patients with fall-related ED visits. Methods This was a secondary analysis of the observational multicenter Acutely Presenting Older Patient (APOP) study, of which a subset of patients aged ≥70 years with fall-related ED visits were prospectively included in EDs of two Dutch hospitals. Fall characteristics (cause and location) were retrospectively collected. The APOP-screener was used as a geriatric screening tool. The outcome was 3- and 12-months functional decline and mortality. We assessed to what extent fall characteristics and the geriatric screening result were independent predictors of the outcome, using multivariable logistic regression analysis. Results We included 393 patients (median age 80 (IQR 76–86) years) of whom 23.0% were high risk according to screening. The cause of the fall was extrinsic (49.6%), intrinsic (29.3%), unexplained (6.4%) or missing (14.8%). A high risk geriatric screening result was related to increased risk of adverse outcomes (3-months adjusted odds ratio (AOR) 2.27 (1.29–3.98), 12-months AOR 2.20 (1.25–3.89)). Independent of geriatric screening result, an intrinsic cause of the fall increased the risk of 3-months adverse outcomes (AOR 1.92 (1.13–3.26)) and a fall indoors increased the risk of 3-months (AOR 2.14 (1.22–3.74)) and 12-months adverse outcomes (AOR 1.78 (1.03–3.10)). Conclusions A high risk geriatric screening result and fall characteristics were both independently associated with adverse outcomes in older ED patients, suggesting that information on both should be evaluated to guide follow-up geriatric assessment and interventions in clinical care.

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Faculty Opinions recommendation of Prospective Validation of The Korean Cancer Study Group Geriatric Score (KG)-7, a Novel Geriatric Screening Tool, in Older Patients with Advanced Cancer Undergoing First-line Palliative Chemotherapy.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.734896958.793589922 ◽

2021 ◽

Author(s):

Maria-José Molina-Garrido

Keyword(s):

Advanced Cancer ◽

Older Patients ◽

Screening Tool ◽

Palliative Chemotherapy ◽

Study Group ◽

First Line ◽

Cancer Study ◽

Cancer Study Group ◽

Geriatric Screening

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Prospective Validation of The Korean Cancer Study Group Geriatric Score (KG)-7, a Novel Geriatric Screening Tool, in Older Patients with Advanced Cancer Undergoing First-line Palliative Chemotherapy

Cancer Research and Treatment ◽

10.4143/crt.2018.451 ◽

2019 ◽

Vol 51 (3) ◽

pp. 1249-1256 ◽

Cited By ~ 1

Author(s):

Jin Won Kim ◽

Se Hyun Kim ◽

Yun-Gyoo Lee ◽

In Gyu Hwang ◽

Jin Young Kim ◽

...

Keyword(s):

Advanced Cancer ◽

Older Patients ◽

Screening Tool ◽

Palliative Chemotherapy ◽

Study Group ◽

First Line ◽

Cancer Study ◽

Cancer Study Group ◽

Geriatric Screening

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Study on intracranial meningioma using PET ligand investigation during follow-up over years (SIMPLIFY)

Neuroradiology ◽

10.1007/s00234-021-02683-1 ◽

2021 ◽

Author(s):

Hanne-Rinck Jeltema ◽

Marnix R. Jansen ◽

Adriaan R. E. Potgieser ◽

Antoinette D. I. van Asselt ◽

Mart A. A. M. Heesters ◽

...

Keyword(s):

Pilot Study ◽

Skull Base ◽

Standardized Uptake Value ◽

Major Change ◽

Intracranial Meningioma ◽

Who Grade ◽

Oncological Treatment ◽

Methionine Uptake ◽

Met Pet

Abstract Purpose Radiologic follow-up of patients with a meningioma at the skull base or near the venous sinuses with magnetic resonance imaging (MRI) after stereotactic radiotherapy (SRT) and neurosurgical resection(s) can be difficult to interpret. This study evaluates the addition of 11C-methionine positron emission tomography (MET-PET) to the regular MRI follow-up. Methods This prospective pilot study included patients with predominantly WHO grade I meningiomas at the skull base or near large vascular structures. Previous SRT was part of their oncological treatment. A MET-PET in adjunct to their regular MRI follow-up was performed. The standardized uptake value (SUV) was determined for the tumor and the healthy brain, on the pre-SRT target delineation MET-PET and the follow-up MET-PET. Tumor-to-normal ratios were calculated, and 11C-methionine uptake over time was analyzed. Agreement between the combined MRI/MET-PET report and the MRI-only report was determined using Cohen’s κ. Results Twenty patients with stable disease underwent an additional MET-PET, with a median follow-up of 84 months after SRT. Post-SRT SUV T/N ratios ranged between 2.16 and 3.17. When comparing the pre-SRT and the post-SRT MET-PET, five categories of SUV T/N ratios did not change significantly. Only the SUVpeak T/Ncortex decreased significantly from 2.57 (SD 1.02) to 2.20 (SD 0.87) [p = 0.004]. A κ of 0.77 was found, when comparing the MRI/MET-PET report to the MRI-only report, indicating no major change in interpretation of follow-up data. Conclusion In this pilot study, 11C-methionine uptake remained remarkably high in meningiomas with long-term follow-up after SRT. Adding MET-PET to the regular MRI follow-up had no impact on the interpretation of follow-up imaging.

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Outcome prioritisation tool for medication review in older patients with multimorbidity: a pilot study in general practice

British Journal of General Practice ◽

10.3399/bjgp17x690485 ◽

2017 ◽

Vol 67 (660) ◽

pp. e501-e506 ◽

Cited By ~ 17

Author(s):

Jojanneke JGT van Summeren ◽

Jan Schuling ◽

Flora M Haaijer-Ruskamp ◽

Petra Denig

Keyword(s):

General Practice ◽

Pilot Study ◽

Health Outcomes ◽

Medication Review ◽

Older Patients ◽

Medication Change ◽

Medication Reviews ◽

The Impact ◽

Medication Changes

BackgroundSeveral methods have been developed to conduct and support medication reviews in older persons with multimorbidity. Assessing the patient’s priorities for achieving specific health outcomes can guide the medication review process. Little is known about the impact of conducting such assessments.AimThis pilot study aimed to determine proposed and observed medication changes when using an outcome prioritisation tool (OPT) during a medication review in general practice.Design and settingParticipants were older patients with multimorbidity (aged ≥69 years) with polypharmacy (five or more chronic medications) from the practices of 14 GPs.MethodPatients were asked to prioritise four universal health outcomes — remaining alive, maintaining independence, reducing pain, and reducing other symptoms — using an OPT. GPs used this prioritisation to review the medication and to propose and discuss medication changes with the patient. The outcomes included the proposed medication change as documented by the GP, and the observed medication change in the electronic health record at follow-up. Descriptive analyses were conducted to determine medication changes according to the prioritised health outcomes.ResultsA total of 59 patients using 486 medications prioritised the four health outcomes. GPs proposed 34 changes of medication, mainly stopping, for 20 patients. At follow-up, 14 medication changes were observed for 10 patients. The stopping of medication (mostly preventive) was particularly observed in patients who prioritised ‘reducing other symptoms’ as most important.ConclusionUsing an OPT leads mainly to the stopping of medication. Medication changes appeared to be easiest for patients who prioritised ‘reducing other symptoms’ as most important.

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