Screening older cancer patients for supportive care needs is recommended but currently not routine. Community-based aged care and carer support agencies are also not utilised routinely. We employed a self-filled geriatric assessment (GA) questionnaire in all patients >70yo at initial presentation to our cancer clinic in regional Australia. Guided intervention ensued using a dedicated cancer care coordinator (CCC). The aim was to assess feasibility and map referral pathways for supportive care with existing, community-funded aged care services.
The GA questionnaire developed by the Royal Adelaide Hospital was adapted to suit local needs. Domains included are comorbidities, activities of daily living (ADLs), Instrumental ADLs, memory, geriatric syndromes, distress thermometer, pain score and level of social supports. This GA was sent to all patients over 70yo before initial presentation to the oncology clinic. The GA was scored by a CCC who then contacted the patient (and carer) by telephone and referred them to support services as required. The tool was readministered at 6 weeks and 6 months.
From 28/3/2011 to 7/2/2012, 155 baseline screens occurred. Median age 78yrs (range 70-95). Male/Female=93/62. Patients with comorbidities (self-reported) = 50%, including memory issues (17%) and falls (20%). Pain reported by 42% and distress by 45% of patients. Up to 45 patients reported at least one problem with IADLs (29%). Total number of supportive care referrals = 73. Key referral destinations were community aged care assessment (n=12), carer support organisations (n=13), palliative care (n=14) and CCCs (n=27). Estimated cost of screening was AUD$42.40 per patient.
This unique model of supportive care screening using a GA questionnaire and guided intervention is feasible, relatively inexpensive and resulted in a significant number of supportive care agency referrals. The oncology and aged-care sectors can collaborate successfully in a community setting.