Nurse navigator–initiated geriatric assessments in hematology/oncology clinics.

Abstract

12051 Background: As the number of older adults with cancer continues to grow, there is an urgent and unmet need to implement geriatric assessments and toxicity screening tools (G8 and CARG toxicity tool) for patients 65 and older with a cancer diagnosis in real-world settings. Studies of these tools show completion rates of 20-35% when administered by a physician. To determine if nurse navigators could increase completion rates, we implemented a pilot in seven community cancer centers within an integrated health system. Methods: A pilot project of G8 and CARG toxicity tool implementation was completed at seven community cancer centers from May 1,2021 to December 31,2021 in patients age ≥ 65 years, with solid or malignant hematologic cancer diagnosis. G8 was administered at seven sites and CARG was assessed in addition to G8 on solid tumor patients undergoing chemotherapy at four of the seven sites. Referrals to nutrition, audiology, physical therapy, psychiatry, and neurology were sent by nurse navigators based on assessment results. Results: The total number of eligible patients for G8 was 1372, with 1082 (78.9 %) successfully completing assessment, and the total number of eligible patients for CARG toxicity tool was 563 with 516 (91.6%) successfully completing assessment. The median age of patients completing assessment was 74 years old (range 65-100) and 52% were female. The cohort included Asian / Pacific Islanders (23%), Black (15%), Hispanic White (8%), and Non-Hispanic Whites (51%). Most common cancers included genitourinary cancer (18%), breast cancer (17%), upper GI cancer (15%), and thoracic cancer (13%). The assessments resulted in referrals to multiple services including nutrition (193 referrals), audiology (30), physical therapy (18), psychiatry (5), and neurology (5). Conclusions: Nurse navigators can successfully implement G8 and CARG toxicity tool in hematology-oncology clinics in a broad range of cancer types at a high rate with resultant referrals to multiple supportive services in real-world settings.