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Health status, emergency department visits, and oncologists' feedback: An analysis of secondary endpoints from a randomized phase II geriatric assessment trial

Abstract

PURPOSE: Geriatric Assessment (GA) can help uncover previously unknown health issues and recommend tailored interventions to optimize outcomes; however, no completed randomized trial has examined the impact of GA on utility-based health status, healthcare use, and oncologists' opinions about GA. We examined these secondary outcomes of a randomized phase II trial. METHODS: A planned analysis of secondary outcomes of a two-group parallel single-blind randomized phase II trial of GA (ClinicalTrials.gov Identifier:NCT02222259) recruited patients>/=age 70, diagnosed with stage II-IV breast/gastrointestinal/genitourinary cancer within six weeks of beginning chemotherapy at the Princess Margaret Cancer Centre, Toronto, Canada. Descriptive analyses using intent-to-treat were conducted for health status (EuroQol EQ-5D-3L) and healthcare utilization (patient self-report). Oncologist opinions were captured via open-ended interviews and summarized. RESULTS: A total of 95 patients who met the inclusion criteria were approached; 61 of them consented (64%). For health status, at all time-points, there were no significant differences between the two groups. The number of emergency department and family physician visits was low overall; there were no statistically significant differences between the two groups at any time point. All interviewed oncologists (eight of fourteen invited) were satisfied with the intervention, but wanted more straightforward recommendations and earlier GA results. CONCLUSIONS: No difference was found in terms of relationships between GA and utility-based health status or GA and healthcare use. Underreporting of healthcare use was possible. Oncologists welcome GA feedback and prefer to receive it in pre-treatment decision context. Larger trials with earlier GA are warranted.

Type Journal
ISBN 1879-4068
Authors Sattar, S.; Alibhai, S. M. H.; Brennenstuhl, S.; Kulik, M.; MacDonald, M. E.; McWatters, K.; Lee, K.; Jang, R.; Amir, E.; Krzyzanowska, M. K.; Joshua, A. M.; Monette, J.; Wan-Chow-Wah, D.; Puts, M. T. E.
Responsible Garvan Author Dr Anthony Joshua
Publisher Name Journal of Geriatric Oncology
Published Date 2019-01-01
Published Volume 10
Published Issue 1
Published Pages 169-174
Status Published in-print
DOI 10.1016/j.jgo.2018.06.014
URL link to publisher's version https://www.ncbi.nlm.nih.gov/pubmed/30041978