REMOTE GERIATRIC ASSESSMENT FOR OLDER PATIENTS INITIATING CHEMOTHERAPY TREATMENT: MULTICENTRIC STUDY

Introduction: The American Society of Clinical Oncology (ASCO) proposes clinical practice guidelines recommending the implementation of geriatric assessment (GA) programs. The guidelines establish, at minimum, assessment of patients’ function, comorbidity, fall risk, depression, cognition and nutrition. This intervention should be integrated and intended to guide the development of individualized treatment plans, addressing patients’ needs across all domains. Objective: This study sought to determine the benefits of a remote GA program among older patients (65+ years) with cancer starting new chemotherapy. Methods: This is a longitudinal, prospective and multicentric study. Older patients (65+ years old), with any type of solid cancer, scheduled to initiate a new chemotherapy treatment in private cancer centers located in 6 different Brazilian states, were included. Patients were contacted via telehealth for assessment of chemotherapy risk (MyCARG toxicity score) and quality of life (Functional Assessment of Cancer Therapy – General). Results: were discussed with a multidisciplinary team, who suggested recommendations to improve patients’ outcomes. A follow-up visit was done 3 months after enrollment, when the GA was performed once again. Results: of the two different assessments were compared using the repeated-measures ANOVA. Results: A total of 61 patients were recruited. Patients had a median age of 76 years (range: 65 – 95 years), were predominantly female (55.7%), married (59.0%) and had at least a high school degree (70.6%). Most patients (78.7%) were diagnosed with advanced disease, being classified at moderate to high risk for toxicity according to the MyCARG Chemo-Toxicity Calculator. Health-related quality of life (HR-QOL) (Mt1 = 94, Mt2 = 101; P = 0.001) improved significantly over time, especially in the physical, emotional and functional domains (Ps=0.001). Conclusion: Patients were able to successfully complete the full course of chemotherapy, reporting improvement in HR-QOL scores. These findings suggest benefits of this remote GA program. Notably, this intervention was feasible via telehealth, presenting itself as a practice that should be more extensively applied to the care of older patients in Brazil.