Abstract
12052 Background: Older cancer patients in developing countries face considerable challenges in obtaining access to specialized medical attention, often due to a lack of human resources and healthcare infrastructure. This study sought to explore the benefit of a remote, validated geriatric assessment (GA) program for older patients starting chemotherapy in Brazil. Methods: Older adults (65+ years) beginning a new chemotherapy treatment regimen in Brazil were recruited. Through telehealth, patients were assessed with GA before starting chemotherapy treatment for any type of solid cancer and at a follow-up visit (3 months after enrollment). GA results were discussed by a multidisciplinary team (e.g., geriatrician, psychologist, nutritionist) and recommendations were determined. Outcome measures included chemo toxicity scores (CARG, scale 0-19), physical symptoms (FACT-G, scale 0-108) and activities of daily living (IADL, scale 0-5 for men and 0-8 for women, or scale 0-1 for IADL ratio). Descriptive statistics were generated, and paired t-tests were used to evaluate the change in these measures over time. Results: A total of 51 older patients from 5 different Brazilian states (Amazonas, Distrito Federal, Espirito Santo, Pernambuco and Rio Grande do Sul) have been enrolled to date. The mean distance from a patients’ home to their place of cancer treatment was 21 miles (range: 3-101 miles). Participants had a mean age of 76.5 years (SD = 7.6) and were predominantly female (57%), white (57%), married (61%), and had a high school degree or more (65%). Patients were mostly diagnosed with gastrointestinal (39%) or gynecological (20%) cancers; 55% of patients were diagnosed with a stage IV disease. The majority of patients (80%) were referred to appropriate remote services based on the GA; including geriatricians (41%), nutritionists (39%) and/or psychologist (16%). At the time of abstract submission, data from 34 complete cases were available for longitudinal analysis, in which we observed a decrease in chemo toxicity scores (M1= 6.65, M2= 5.88, p = 0.035) and an improvement in FACTG (M1= 92.94, M2= 98.53, p < 0.001). The improvement in IADL ratio was not significant (M1= 0.79, M2= 0.85, p = 0.069). Conclusions: This novel, ongoing study is, to our knowledge, the first to implement a remote GA program in Brazil. Our preliminary findings suggest that a remote GA program, with appropriate referrals to specialists, may increase the reach of supportive services and improve cancer care in developing countries.
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