Background:Despite evidence supporting the benefits of geriatric screening and assessment for older adults with cancer, specialised geriatric oncology programs in Australia remain limited. Multimorbidity and geriatric syndromes are prevalent among this population, and supportive services beyond cancer-specific treatment are critical to providing optimal person-centred cancer care. Innovative models of care are essential to address growing healthcare demand and disparities.
Aim:To implement and evaluate a nurse-led model of care for screening and assessing geriatric needs in older adults with lung cancer.
Method:A nurse-led geriatric oncology model of care was co-designed with key stakeholders, including consumers. A nurse used validated tools to screen and assess all new patients with lung cancer aged 65+ or 50+ for Aboriginal and Torres Strait Islander peoples. Based on the assessment, a pathway of care included nursing referrals to allied health and specific triggers identifying those needing a multidisciplinary geriatric assessment. Patients were subsequently discussed at a multidisciplinary team meeting, with a letter generated to the patient's GP.
Results:Over 12 months, 100 patients were assessed by the nurse. The median age was 73.5(range 65-87). Of the 89 patients who had treatment, 70(79%) were seen prior to, 5(6%) were seen on the day of, and 14(16%) were seen after commencement of treatment. The most frequently reported issues included polypharmacy(40%), depression(18%), mobility(18%), and cognition(12%). Patients were referred to allied health in 78% of cases, while 7% were referred to a Geriatrician via their GP. All patients were discussed at the nurse-led MDT meeting and received a follow-up call at 4-6 weeks. Patients surveyed reported high satisfaction/acceptability, with 98% expressing positive feedback.
Conclusion:Innovative nurse-led models of care increase evidence-based care for older adults with cancer. This intervention provides workflow processes for screening and assessment of geriatric syndromes that can be tailored to health services worldwide.