Geriatric assessment and management with question prompt list using a web-based application for elderly patients with cancer to communicate aging-related concerns: A randomized clinical trial (J-SUPPORT 2101 study).

  • Ayumu Matsuoka
    Division of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
  • Maiko Fujimori
    Division of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
  • Narikazu Boku
    Department of Oncology and General Medicine, IMSUT Hospital, Institute of Medical Science, University of Tokyo, Tokyo, Japan
  • Atsuo Takashima
    Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
  • Takuji Okusaka
    Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
  • Ken Kato
    Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
  • Yuta Maruki
    Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
  • Akihiro Ohba
    Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
  • Hidekazu Hirano
    Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
  • Keita Mori
    Clinical Trial Coordination Office, Shizuoka Cancer Center, Shizuoka, Japan
  • Tatsuo Akechi
    Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Yukari Tsubata
    Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Izumo, Japan
  • Tomohiro F. Nishijima
    Geriatric Oncology Service, NHO Kyushu Cancer Center, Fukuoka, Japan
  • Taichi Shimazu
    Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
  • Tempei Miyaji
    Division of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
  • Yoshiyuki Majima
    NPO Pancreatic Cancer Action Network Japan, Sodegaura, Japan
  • Takayo Sakiyama
    Division of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
  • Kyoko Obama
    Division of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
  • Fumio Nagashima
    Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan
  • Yosuke Uchitomi
    Division of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan

この論文をさがす

説明

<jats:p> 1511 </jats:p><jats:p> Background: Older adults with cancer have aging-related physical and psychosocial problems that should be fully shared with their oncologists. Geriatric assessment (GA) can assess these aging-related problems and guide management. Communication support might also facilitate implementation of GA-guided management (GAM). We conducted this single-blind, parallel-group, multicenter, randomized controlled trial to evaluate the efficacy of a program providing GAM recommendation and communication support between older Japanese patients with cancer and their oncologists. Methods: Eligibility criteria were age≥70 years, advanced or recurrent cancers of gastrointestinal origin, referral to one of the two institutions for first- or second-line systemic therapy, and impairment in at least one GA domain as assessed using a web-based application at baseline. In the intervention group, GAM recommendations and question prompt list (QPL) were provided to patients by trained intervention providers to be shared with their oncologists at the first outpatient visit after randomization. Over 5 months after the initial intervention, implementation of GAM recommendations was reviewed monthly by the intervention providers with the patients and their oncologists. Patients in the control group received usual care. The primary endpoint was the number of conversations about aging-related concerns at the first visit. The quality of conversations was assessed in terms of the number of conversations in which stated concerns were acknowledged and considered further by the oncologist and the number of conversations in which acknowledged concerns motivated implementation of GAM recommendations. Results: A total of 215 patients (99 women, 116 men; median age 75 [range 70-88] years) were randomized (n=108/107 in the intervention/control group) between September 2021 and September 2023. There were no differences between two groups in patient background characteristics including the prevalence of GA impairments. The number of conversations about aging-related concerns was significantly higher in the intervention group than in the control group (mean [SD] 2.95 [1.53] vs. 1.90 [1.49], p<0.0001). The number of high-quality conversations and number of conversations about GAM recommendations were also significantly higher in the intervention group than in the control group (1.73 [1.40] vs. 1.12 [1.16], p=0.001; 0.57 [0.74] vs. 0.28 [0.47], p=0.001, respectively). Conclusions: Our program providing GAM recommendations and communication support successfully facilitated aging-related communications between patients and their oncologists. We will further examine whether facilitated communication leads to actual implementation of GAM and improved patient health outcomes in a follow-up study. Clinical trial information: UMIN000045428 . </jats:p>

収録刊行物

  • Journal of Clinical Oncology

    Journal of Clinical Oncology 42 (16_suppl), 1511-1511, 2024-06-01

    American Society of Clinical Oncology (ASCO)

被引用文献 (1)*注記

もっと見る

詳細情報 詳細情報について

問題の指摘

ページトップへ