Implementing the ASCO PGA in a remote Australian setting.

Abstract

e13853 Background: Hamilton is a remote Australian town of 10,000 residents. With limited access to visiting oncologists, it has become apparent that integrating a telehealth model into the existing oncology service is essential to address the needs of cancer patients. Our community comprises a substantial proportion of elderly patients who frequently present with impairments and pre-existing chronic conditions, thereby increasing the risk of complications during cancer treatment. Geriatric assessments provide valuable insights into the daily lives of vulnerable elderly patients, emphasising key areas typically overlooked in conventional assessments. We have identified the ASCO PGA tool as suitable for our purposes. Methods: Starting in Feb 2024, we started an exclusively telehealth model of geriatric oncology. The multidisciplinary meeting (MDM) is held every second week and attended by a geriatric oncologist from an academic centre with local providers including an oncology nurse, palliative care nurse, dietitian, occupational therapist, physiotherapist, and exercise physiologist. The PGA is administered by a nurse and discussed at the MDM prior to the initial medical oncology consultation. The assessment results, other pertinent information, and recommendations are recorded in the EMR. Results: 40 patients were referred by their oncologist to the service. 36 were administered a PGA by an oncology nurse. Of these 36 patients, 10 died, 6 required no allied health/palliative care interventions and 6 patients disengaged. A user satisfaction survey (patient and provider) is planned to be implemented before May 2025. Conclusions: During the preliminary study, the PGA proved to be practical and straightforward to administer. It was comprehensible to both professionals and providers. The PGA augments broader awareness of geriatric vulnerabilities and facilitates early allied health interventions, thereby supporting a patient-centred approach to cancer care. PGA domains and outcomes. PGA DOMAINS & Other Measured Outcomes N = 36 Percentage (%) Physical Function: Falls >1 5 13.8 Functional Status: ADLs (need some help/unable) 30 83 Social Supports (none, a little, some of the time) 9 25 Nutritional (>3 kg weight loss) 6 16 Comorbidity (>3) 18 50 Cognitive Function (Mini-Cog <2) 2 5.5 Did not receive chemotherapy/dose-modified 3 8.3 Polypharmacy (>5 medications) 13 36 Deceased 10 27.7