Older cancer patients should receive an interdisciplinary approach to care due to the frequent intersection of multiple medical and psycho-social issues.
- To develop a model of geriatric oncology service which utilizes existing resources and is coordinated by a social worker to attain the following outcomes:
- To assess for change in management based on multidisciplinary team approach.
- To assess morbidity and mortality data.
- Patient and carer satisfaction.
- To assess for early referrals to allied health and palliative care intervention in symptom management.
Methods:
- All patients >80 years with newly diagnosed solid cancers referred to Department of Medical Oncology are directed to the Geriatric Oncology Service.
- All patients are assessed by the social worker coordinator using specific tools and discussed in a multidisciplinary team meeting.
- Patients are reviewed by medical oncologists and geriatricians on the same day.
- The clinic will assess for fitness for treatment, optimisation of co morbidities and psychosocial issues. Follow up phone calls to request feedback on the service.
Results:
1. The first clinic was held on 26th October 2016.
2. 59 patients were eligible for the clinic from 1st October 2016 to 30th April 2017 (64% from ACT and 36% from adjoining areas from NSW).
3. 10 patients excluded (4 patients refused to attend, 2 patient did not have diagnosis and 4 were referred to different specialty)
- 71.43% fit patients, 20.40% borderline and 8.17% frail patients were identified based on assessments.
- 42/49 patients provided feedback with regards to the service. The responses were mostly positive with inter –rater variability of 66-90%.
4. This remains an ongoing service.
Clinical Significance:
This social worker led model of care has been a feasible service utilising existing resources in our centre in providing specialist multidisciplinary care to geriatric oncology patients. However, this needs further validation in ongoing studies and analysis of outcome data.