Patient satisfaction with geriatric and functional assessments and referral to frailty-related interventions among older adults presenting to the University of Colorado Urologic Oncology Multidisciplinary Clinic.

Abstract

TPS273 Background: Geriatric assessments (GA) are valuable tools for determining the functional age of patients and represent the standard of care in evaluating vulnerabilities in older adults with cancer. In oncological treatment, these assessments can help refer patients to appropriate ancillary resources, such as physical therapists, registered dietitians, and social workers, while also assisting in selecting chemotherapy regimens, surgical interventions, and radiation therapy plans. GA and GA-guided management have been shown to positively impact treatment completion and reduce chemotherapy-related toxicity in two recent randomized clinical trials. However, there is minimal data assessing patient satisfaction with the interventions provided through this assessment. This study aims to evaluate patient experiences and acceptance of GA and fragility-based referrals recommended by GA, while also identifying patient-reported barriers to accessing these referred resources. Understanding patient acceptability towards geriatric and functional assessments, along with the determinants and barriers to referral completion, can provide additional information to improve oncologic care for older patients. Methods: This is a single-center feasibility study enrolling patients aged 65 and older who are diagnosed with genitourinary cancer and present to the University of Colorado Urologic Oncology multi-disciplinary conference (MDC). The primary endpoint is the patient-reported acceptability of incorporating geriatric and functional assessments. The secondary endpoint is patient-reported determinants and barriers to completing appropriate referrals based on findings from the GA. Patients will undergo a Practical Geriatric Assessment (PGA) and a Stopping Elderly Accidents, Deaths, and Injuries (STEADi) assessment. Based on their functional score, patients will be referred to Cancer Rehabilitation Medicine, physical therapy, occupational therapy, or the BfitBwell exercise program. Additionally, if the patient’s weight has decreased by more than 3 kilograms in the 3 months prior to their visit, they will be referred for nutritional support. Patients will also be referred to social services if they report significant concerns regarding their ability to manage daily living activities or if they lack adequate social support. Patient acceptability will be collected using validated acceptability of intervention surveys. Semi-structured qualitative interviews will be conducted 8 weeks after the patient’s MDC visit, focusing on patient-reported determinants and barriers to completing fragility-related referrals.