Suitability of an Organization With an Onco-geriatric Team to a Whole Region (Region Midt) of Denmark
Condition: Elderly; Cancer
Study type: Interventional

Summary: 
      A Feasibility study Geriatric assessment applied to patients with cancer of the head and
      neck, lung cancer, upper gastrointestinal cancer or colo-rectal cancer. On the day of
      planning the oncologic treatment Comprehensive Geriatric Assessment (CGA) will be offered to
      patients aged 70 years and up. Based on the CGA a tailored multidisciplinary intervention is
      planned with the patients. The study aims 1) to investigate if it is feasible to offer CGA to
      all elderly (+70 years) patients with the relevant cancer diagnoses as mentioned above in The
      Central Denmark Region (Region Midt) , 2) to estimate the proportion of frail, vulnerable or
      fit elderly cancer patients, 3) to investigate the impact of a CGA on the planned oncologic
      treatment intensity, and 4) to investigate the ability of CGA to predict complications to
      cancer treatment within a three months period.
    

Detailed description: 
      Aim:

      The study aims 1)to investigate if it is feasible to offer CGA to all elderly (+70 years)
      patients with the relevant cancer diagnoses as mentioned above in The Central Denmark Region
      (Region Midt) , 2) to estimate the proportion of frail, vulnerable or fit elderly cancer
      patients, 3) to investigate the impact of a CGA on the planned oncologic treatment intensity
      and 4)to investigate the ability of CGA to predict complications to cancer treatment within a
      three months period.

      Method:

      All patients referred to the oncology Departement aged 70 years or more with cancer of the
      head and neck, lung cancer, upper gastrointestinal cancer or colo-rectal cancer, Living in
      the Central Denmark Region (Region Midt) are offered af Comprehensive Geriatric Assessment
      (CGA) on the day of the visit to the oncology outpatient Clinic. Prior to the first visit to
      the oncology department, the patients are informed that a CGA is planned..The CGA will take
      place at the outpatient clinic. The results of the CGA, the eventual medical changes and
      recommendations regarding e.g. initiation of nutritional supplementation, home-care referral
      or referral to e.g. physiotherapist will be forwarded to the general practitioner and to the
      oncologist in charge of the treatment.

      Outcome:

        1. The possibility of offering CGA to elderly cancer patients in a larger area, the
           proportion of patients offered CGA by the oncogeriatric team compared to the actual
           number of elderly cancer patients assessed by oncologists during a three months period.

        2. The number of frail vs. vulnerable vs. fit persons is estimated from hospital records
           and the CGA observations. Their dependency in Activities of Daily Living (ADL) and
           Instrumental Activities og Daily Living (IADL), their cognitive, depressive and
           nutritional status and the medication problems are registered as well as the changes in
           patient´s medication.

        3. The impact of CGA on the oncologist´s treatment plan.

        4. The Complications, defined as discontinuation of treatment, hospitalization for other
           reasons than planned cancer treatment, or death, within the first three month following
           CGA.
    

Intervention name(s): Comprehensive geriatric assessment
Intervention type(s): Other
Intervention description(s): Intervention is planned to be based on the findings of the geriatric assessment and could include optimizing on comorbidity, planning of physical exercise, improvement of the social situation and nutritional status.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: frailty; oncogeriatrics; Multidisciplinary intervention; multimorbidity; Comprehensive geriatric assessment; patients