How are Geriatric Assessment Domains and Age Discussed in Cancer Multidisciplinary Meetings? (#153)
Background: Medical comorbidities, polypharmacy, physical function, cognition and psychosocial issues impact on treatment tolerance for older people with cancer. These factors, which are standard components of geriatric assessments, may not routinely be considered in cancer multidisciplinary meetings (MDMs), and little is known about how they are described.
Aim: To investigate whether age and geriatric assessment domains are discussed in cancer MDMs and to examine the terminology used to describe these domains.
Methods: Twenty cancer MDMs were attended, across four tumour streams. Phrases describing age and geriatric assessment domains were hand recorded for patients discussed who were aged 70 and over. Descriptive statistics were used to analyse the frequency with which age and geriatric assessment domains were discussed. A thematic analysis was undertaken to explore the terminology used to describe age and geriatric assessment domains.
Results: Data were collected for 68 people aged 70 and over. Age (82%) and comorbidities (56%) were usually described, general descriptors such as ‘fit’, ‘well’ and ‘good’ were commonly used (40%), however, other geriatric assessment domains, including social situation (17%) and physical function (10%), were infrequently mentioned. General descriptors may vary in meaning between clinicians. ‘Fit’ was used both as a general descriptor and used in the context of ‘fitness’ for treatment. Modifying adverbs including ‘very’, ‘pretty’ and ‘quite’ often accompanied general descriptors. These potentially vary in meaning depending on context and intonation.
Conclusions: In addition to describing age and comorbidities, general descriptors of older people were commonly used. These descriptors were not objective and associated modifying adverbs were potentially ambiguous. Such terms potentially influence decisions reached. However, the use of general descriptors indicates awareness that factors other than comorbidities and age are important to treatment decisions.