Abstract
Background: There are no guidelines available for what assessment tools to use in a patient’s self-completed online geriatric assessment (GA) with management recommendations. Therefore, we used a modified Delphi approach with Canadian expert clinicians to develop a consensus online GA plus recommendations tool. Methods: The panel consisted of experts in geriatrics, oncology, nursing, and pharmacy. Experts were asked to rate the importance and feasibility of assessments and interventions to be included in an online GA for patients. The items included in the first round were based on guidelines for in-person GA and literature review. The first two rounds were conducted using an online survey. A virtual 2 h meeting was held to discuss the items where no consensus was reached and then voted on in the final round. Results: 34 experts were invited, and 32 agreed to participate. In round 1, there were 85 items; in round 2, 50 items; and in round 3, 25 items. The final tool consists of fall history, assistive device use, weight loss, medication review, need help taking medication, social supports, depressive symptoms, self-reported vision and hearing, and current smoking status and alcohol use. Conclusion: This first multidisciplinary consensus on online GA will benefit research and clinical care for older adults with cancer.
Highlights
Cancer is a disease that predominantly affects older adults [1]
The possible assessment tools and recommendations per geriatric assessment (GA) domain were based on a review of current GA guidelines/recommendations for the oncology setting [2,3], previous Delphi panel studies for in-person GA [12,13], and a review of validated assessment tools included in other guidelines
The actual validated assessment tools were included in the online survey so that all participants could review the tool before voting on its importance and feasibility
Summary
Cancer is a disease that predominantly affects older adults [1]. With the aging of the population, there will be an increase in the number of older adults with cancer [1]. The ASCO guideline [2] includes suggestions for assessment tools for these GA domains as well as and recommendations for the clinician to consider when the GA shows an impairment in that geriatric domain [2]. A GA for older adults with cancer has been shown to reduce treatment toxicity [6,7] and improve treatment completion [8], and improves function as measured by the Elderly Functional Index (ELFI) [9]. The ASCO guideline, as well as previous conducted Delphi panel studies to develop consensus on GA for older adults with cancer [12,13], included assessment tools that need to be administered in person (such as cognitive screening or performance-based tests of balance, strength, and mobility) and cannot be transferred to an online environment. Conclusion: This first multidisciplinary consensus on online GA will benefit research and clinical care for older adults with cancer
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