Aim: The 2023 Australian Cancer Plan highlights the disparities in cancer outcomes for older adults and people living in rural and remote areas. The plan’s Health Equity framework recognises the importance of optimised treatment and support that is tailored to personal contexts. Our team has been working toward tailored and optimised treatment and support for regionally based older adults diagnosed with cancer through the adoption and implementation of age-friendly oncology practices such as geriatric assessment.
Methods: We applied the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) to design multiple key projects that have been undertaken over the previous 3 years; with more in development or currently underway. Input from people with lived experience of cancer has been a cornerstone of our work and has led to the development of innovative solutions to implementing age-friendly supportive care.
Results: The approach taken yielded two iterations of an innovative assessment method for older adults based on the 4Ms method of age-friendly care (Mentation, Medication, Mobility and what Matters). Both iterations of the assessment were found to be acceptable to both patients and clinicians, and their implementation was feasible at a regional cancer centre. In line with i-PARIHS principles, we have undertaken Roadshows to other cancer centres to present the evidence base for implementation and have engaged site champions. As a result, planning for a multi-site implementation study is now underway.
Conclusion: By utilising rigorous implementation methods, engaging a complex change management process, and working with older adults with lived experience of a cancer diagnosis, changes in practice are achievable. Our experience has taught us that there is enthusiasm for appropriate assessment of older adults in cancer care, and providing a practical example combined with engaging site champions is key to leveraging that enthusiasm.