Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Establishment of the Peninsula Health Oncology And Supportive Intervention Service (OASIS) –Bridging the gaps to improve care of the older patient living with cancer (#442)

Sandra Maciver 1 , Joanne Lundy 2 3 , Anjali Khushu 4 , Michael Choi 4 , Baheerathan Narayanan 5 , Joan Thomas 1 , Rohan White 6 , Zoe Thomas 1
  1. Cancer Services, Peninsula Health, Frankston, VIC, Australia
  2. Department of Oncology, Peninsula Health, Frankston, VIC, Australia
  3. Peninsula Clinical School, Central Clinical School, Monash University, Frankston, VIC, Australia
  4. Geriatric Medicine, Peninsula Health, Frankston, VIC, Australia
  5. Rehabilitation Medicine, Peninsula Health, Frankston, VIC, Australia
  6. Community Health, Peninsula Health, Rosebud, VIC, Australia

Introduction

Individuals aged 65 years and older represent approximately half of the Peninsula Health (PH) oncology patient population. This cohort is more likely to have pre-frailty/frailty and are at increased risk of systemic therapy intolerance, postoperative complications and mortality. Current guidelines recommend extension of the cancer multidisciplinary team to include geriatric expertise including integration of formal screening/assessment processes to optimise care of older persons with cancer.

Aims

OASIS is a collaborative service aiming to integrate expertise in oncology, geriatrics and rehabilitation medicine into the existing model of care within PH Cancer Services. It aims to optimise care and outcomes for older patients with cancer at all points of the cancer journey, including diagnosis, treatment and survivorship to improve health and resilience in this high-risk cohort.

Model of Care

All patients >65 are screened (G8 tool) and referred into Rehabilitation/Geriatrician clinic dependent on G8 score. A nurse-led clinic conducts pre-clinic assessments including multi-domain Comprehensive Geriatric Assessment. MDT case conferences (with Oncologist, Geriatrician, Rehabilitation Physician, CNC, Allied health) occur within a week of review to formulate individualised care plans/interventions, which are fed back to treating GPs/oncologists. Care delivery is designed to integrate with existing Peninsula Health/external cancer care services.

Results

The service was established in March 2024 with seed funding from a SMICS grant, with projections to be financially self-sustaining from Year 3.

To date, 83 patients have been referred to the service, with 76% referred to the Geriatric Stream (GS) and 24% to the Rehabilitation Stream (RS). The most prevalent interventions were referral to a Cancer Rehab Program (60% GS/83% RS), medication management (50% GS, 33% RS), further investigation (30% GS), other allied health referral (25%), GP review (15%), palliative care (10%), other lifestyle interventions (10%) and the Better@Home Program (5%). The program has been strongly supported by clinicians and patients.

  1. Health Information Services Peninsula Health Frankston VIC 3199
  2. William Dale et al., Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy: ASCO Guideline Update. JCO 41, 4293-4312(2023). DOI:10.1200/JCO.23.00933
  3. Magnuson A, Dale W, Mohile S. Models of Care in Geriatric Oncology. Curr Geriatr Rep. 2014 Sep;3(3):182-189. doi: 10.1007/s13670-014-0095-4. PMID: 25587518; PMCID: PMC4289627.
  4. Garcia MV, Agar MR, Soo W, To T, Phillips JL. Screening Tools for Identifying Older Adults With Cancer Who May Benefit From a Geriatric Assessment: A Systematic Review. JAMA Oncol. 2021;7(4):616–627. doi:10.1001/jamaoncol.2020.6736