scholarly journals PATIENT-REPORTED OUTCOME (PRO) COMPLETION IN OLDER ADULTS WITH ADVANCED CANCER; A UNIVERSITY OF ROCHESTER NATIONAL CANCER INSTITUTE COMMUNITY ONCOLOGY RESEARCH (UR-NCORP) PROGRAM TRIAL

2019 ◽  
Author(s):  
Marie Flannery ◽  
Eva Culakova
Keyword(s):  
Older Adults ◽  
Advanced Cancer ◽  
National Cancer Institute ◽  
Patient Reported Outcome ◽  
Oncology Research ◽  
Community Oncology ◽  
Patient Reported

A geriatric assessment (GA) intervention for older patients with advanced cancer: Secondary outcomes from a University of Rochester cancer center NCI community oncology research program cluster randomized controlled trial (CRCT).

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 33-33
Author(s):  
Supriya Gupta Mohile ◽  
Mostafa Mohamed ◽  
Huiwen Xu ◽  
Amita Patil ◽  
Eva Culakova ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Older Patients ◽  
Controlled Trial ◽  
Depression Scale ◽  
Cancer Center ◽  
Oncology Research ◽  
Community Oncology ◽  
Treatment Type ◽  
Patient Reported ◽  
Secondary Outcomes

33 Background: GA evaluates aging-related domains (e.g., function) known to be associated with cancer treatment toxicity. We found that providing a GA summary with management recommendations to oncologists reduces clinician-rated toxicity in older patients (pts) with advanced cancer receiving high risk treatment (presented @ASCO2020). Herein, we report secondary outcomes on the effects of the GA intervention on aging-related outcomes. Methods: Pts aged ≥ 70 with incurable solid tumors or lymphoma and ≥ 1 impaired GA domain starting a new treatment regimen were enrolled. Community oncology practices were randomized to intervention (oncologists received GA summary/recommendations) or usual care (none given). Secondary analyses examined effects of the intervention on functional outcomes (patient-reported falls, instrumental activities of daily living (IADL), short physical performance battery (SPPB), geriatric depression scale (GDS), and medications [total and prescription]). Outcomes were analyzed using linear mixed effects model, logistic or Poisson regression adjusted for baseline values, time, and site effects as appropriate. Results: From 2013-19, 718 pts were enrolled from 41 practices. Age (mean 77 yrs), sex (43% women), number of impaired GA domains (median 4/8), and treatment type (chemotherapy 88%) were not different by arm. More pts in intervention were black (12% vs 3%, p<0.01), had GI cancer (38% vs 31%, p<0.01), and had prior chemotherapy (31% vs 23%, p=0.02). Overall, 16.4% of all pts had one new fall over 3 months; patients in the intervention arm were significantly less like to fall over 3 months (11.7% vs 20.7%; Risk Ratio 0.58; 95% CI 0.40-0.84, p=0.004). There was no difference in the total number of medications (mean 5.86 vs 5.79, p=0.80) and prescriptions (mean 4.26 vs 4.20, p=0.70) at baseline. More medications (adjusted mean 0.23 vs 0.09, p=0.03) and prescriptions (0.19 vs 0.07, p=0.05) were discontinued during intervention, although there was no difference at 3 month follow up. There were no significant between-arms differences in IADL, SPPB, and GDS. Conclusions: Providing GA information to oncologists reduces the proportion of older pts who experience a fall over 3 months and improves polypharmacy; both of these endpoints are of clinical importance to older adults with aging-related conditions and advanced cancer undergoing palliative treatment. Funding: R01CA177592, U01CA233167, UG1CA189961. Clinical trial information: NCT02054741 .

Completion of Patient-Reported Outcome Questionnaires among Older Adults with Advanced Cancer

2021 ◽  
Author(s):  
Marie A. Flannery ◽  
Supriya Mohile ◽  
Eva Culakova ◽  
Sally Norton ◽  
Charles Kamen ◽  
...  
Keyword(s):  
Older Adults ◽  
Advanced Cancer ◽  
Patient Reported Outcome ◽  
Patient Reported

scholarly journals Evolution of Cancer Care Delivery Research in the NCI Community Oncology Research Program

2019 ◽  
Vol 112 (6) ◽  
pp. 557-561 ◽  
Author(s):  
Ann M Geiger ◽  
Ann M O’Mara ◽  
Worta J McCaskill-Stevens ◽  
Brenda Adjei ◽  
Priyanga Tuovenin ◽  
...  
Keyword(s):  
Research Program ◽  
National Cancer Institute ◽  
Cancer Care ◽  
Care Delivery ◽  
Well Being ◽  
Practice Change ◽  
Evidence Based ◽  
Oncology Research ◽  
Community Oncology ◽  
Robust Portfolio

Abstract Research seeking to improve patient engagement with decision-making, use of evidence-based guidelines, and coordination of multi-specialty care has made important contributions to the decades-long effort to improve cancer care. The National Cancer Institute expanded support for these efforts by including cancer care delivery research in the 2014 formation of the National Cancer Institute Community Oncology Research Program (NCORP). Cancer care delivery research is a multi-disciplinary effort to generate evidence-based practice change that improves clinical outcomes and patient well-being. NCORP scientists and community-based clinicians and organizations rapidly embraced the addition of this type of research into the network, resulting in a robust portfolio of observational studies and intervention studies within the first 5 years of funding. This commentary describes the initial considerations in conducting this type of research in a network previously focused on cancer prevention, control, and treatment studies; characterizes the protocols developed to date; and outlines future directions for cancer care delivery research in the second round of NCORP funding.

Standardised approach to measuring goal-based outcomes among older disabled adults: results from a multisite pilot

2020 ◽  
pp. bmjqs-2019-010742
Author(s):  
Erin R Giovannetti ◽  
Catherine A Clair ◽  
Lee A Jennings ◽  
Shana F Sandberg ◽  
Angelia Bowman ◽  
...  
Keyword(s):  
Older Adults ◽  
Goal Attainment ◽  
Health Management ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Goal Attainment Scaling ◽  
Care Needs ◽  
Trade Offs ◽  
Patient Reported ◽  
Specific Care

BackgroundOlder adults with complex care needs face trade-offs in determining the right course of treatment. The Centers for Medicare and Medicaid Services identified ‘Care is personalized and aligned with patient’s goals’ as a key meaningful measures category, yet existing quality measures typically assess disease-specific care and may not effectively evaluate what is most important to older adults and family members. Measures based on individualised goals and goal-based outcomes have been proposed as an alternative but are not routinely assessed or implemented.ObjectivesWe tested two approaches to assessing goal-based outcomes that allow individuals to set goals based on their own priorities and measure progress—(1) goal attainment scaling and (2) existing, validated patient-reported outcome measures (PROM).MethodsA prospective cohort study of feasibility in seven sites (33 clinicians) of the two approaches with 229 individuals. We calculated performance on a measure of achievement of individually identified goals.ResultsBoth approaches were successfully implemented in a non-randomly selected population, and a goal-based outcome could be calculated for 189 (82%) of participants. Most individuals met their goal-based outcome (73%) with no statistical difference between the goal attainment scaling approach (74%) and the patient-reported outcomes approach (70%). Goals were heterogeneous ranging from participating in activities, health management, independence and physical health. Clinicians chose to use goal attainment scaling (n=184, 80%) more often than PROMs (n=49, 20%) and rated the goal attainment scaling approach as useful for providing patient care.ConclusionGoal-based outcomes have the potential to both improve the way healthcare is provided and fill a critical gap in value-based payment.

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