Implementation of a Multi-Disciplinary Geriatric Oncology Clinic in Toronto, Canada

Older adults with cancer tend to face more complex health needs than their younger counterparts. Patients > 65 years of age are recommended for comprehensive geriatric assessment (CGA) to capture and address age-related vulnerabilities. Access to geriatrics services is limited, and our baseline a...

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Main Authors: Ines B. Menjak, Khloe Campos, Mark Pasetka, Arlene Budden, Elaine Curle, Leslie Gibson, Ewa Szumacher, Rajin Mehta
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/32/2/89
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author Ines B. Menjak
Khloe Campos
Mark Pasetka
Arlene Budden
Elaine Curle
Leslie Gibson
Ewa Szumacher
Rajin Mehta
author_facet Ines B. Menjak
Khloe Campos
Mark Pasetka
Arlene Budden
Elaine Curle
Leslie Gibson
Ewa Szumacher
Rajin Mehta
author_sort Ines B. Menjak
collection DOAJ
description Older adults with cancer tend to face more complex health needs than their younger counterparts. Patients > 65 years of age are recommended for comprehensive geriatric assessment (CGA) to capture and address age-related vulnerabilities. Access to geriatrics services is limited, and our baseline audit of geriatric referrals in 2019 from the cancer program revealed that only 30% of patients referred received a CGA. The aim of this study was to assess the implementation of a geriatric oncology (GO) clinic that employs CGA and determine patient outcomes. We conducted a retrospective cohort study at a single institution. Data collection included baseline characteristics, GO clinic findings and characteristics, recommendations/referrals, and emergency room (ER) visits/hospitalizations within 6 months of CGA. Descriptive statistics were used for analysis. A total of 100 patients were included, with a median (range) age of 80 (63–97) years; 70% were female, and the most common cancer type was breast (31%). Through the GO clinic, patients were seen in a timely manner, with a median of 3 weeks, compared to our historical baseline of 11 weeks. Cognitive decline (32%) and pre-treatment CGA (22%) were the most common reasons for referral, and the most common new diagnosis was cognitive impairment (65%). For pre-treatment CGA, 16 (48%) patients were deemed suitable for treatment and 10 (30%) were recommended for modified treatment; 34 (94%) referring physicians followed the recommendation. In addition, most (68%) patients received an allied health referral. One third of patients visited the ER and 30 (30%) patients were hospitalized. Overall, the GO clinic resulted in greater access to CGA in a timely manner, enhanced access to allied health, and assisted in treatment decision-making.
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spelling doaj-art-693b7a5b9e7d4bbd966b28b2c1fb683b2025-08-20T02:44:53ZengMDPI AGCurrent Oncology1198-00521718-77292025-02-013228910.3390/curroncol32020089Implementation of a Multi-Disciplinary Geriatric Oncology Clinic in Toronto, CanadaInes B. Menjak0Khloe Campos1Mark Pasetka2Arlene Budden3Elaine Curle4Leslie Gibson5Ewa Szumacher6Rajin Mehta7Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, CanadaDepartment of Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON M4N 3M5, CanadaDepartment of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, CanadaDepartment of Nursing, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, CanadaDepartment of Nursing, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, CanadaDepartment of Occupational Therapy, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, CanadaDepartment of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, CanadaDepartment of Medicine, University of Toronto, Toronto, ON M5S 1A1, CanadaOlder adults with cancer tend to face more complex health needs than their younger counterparts. Patients > 65 years of age are recommended for comprehensive geriatric assessment (CGA) to capture and address age-related vulnerabilities. Access to geriatrics services is limited, and our baseline audit of geriatric referrals in 2019 from the cancer program revealed that only 30% of patients referred received a CGA. The aim of this study was to assess the implementation of a geriatric oncology (GO) clinic that employs CGA and determine patient outcomes. We conducted a retrospective cohort study at a single institution. Data collection included baseline characteristics, GO clinic findings and characteristics, recommendations/referrals, and emergency room (ER) visits/hospitalizations within 6 months of CGA. Descriptive statistics were used for analysis. A total of 100 patients were included, with a median (range) age of 80 (63–97) years; 70% were female, and the most common cancer type was breast (31%). Through the GO clinic, patients were seen in a timely manner, with a median of 3 weeks, compared to our historical baseline of 11 weeks. Cognitive decline (32%) and pre-treatment CGA (22%) were the most common reasons for referral, and the most common new diagnosis was cognitive impairment (65%). For pre-treatment CGA, 16 (48%) patients were deemed suitable for treatment and 10 (30%) were recommended for modified treatment; 34 (94%) referring physicians followed the recommendation. In addition, most (68%) patients received an allied health referral. One third of patients visited the ER and 30 (30%) patients were hospitalized. Overall, the GO clinic resulted in greater access to CGA in a timely manner, enhanced access to allied health, and assisted in treatment decision-making.https://www.mdpi.com/1718-7729/32/2/89geriatriconcologygeriatric assessmentdecision-makinggeriatric oncology clinicallied health
spellingShingle Ines B. Menjak
Khloe Campos
Mark Pasetka
Arlene Budden
Elaine Curle
Leslie Gibson
Ewa Szumacher
Rajin Mehta
Implementation of a Multi-Disciplinary Geriatric Oncology Clinic in Toronto, Canada
Current Oncology
geriatric
oncology
geriatric assessment
decision-making
geriatric oncology clinic
allied health
title Implementation of a Multi-Disciplinary Geriatric Oncology Clinic in Toronto, Canada
title_full Implementation of a Multi-Disciplinary Geriatric Oncology Clinic in Toronto, Canada
title_fullStr Implementation of a Multi-Disciplinary Geriatric Oncology Clinic in Toronto, Canada
title_full_unstemmed Implementation of a Multi-Disciplinary Geriatric Oncology Clinic in Toronto, Canada
title_short Implementation of a Multi-Disciplinary Geriatric Oncology Clinic in Toronto, Canada
title_sort implementation of a multi disciplinary geriatric oncology clinic in toronto canada
topic geriatric
oncology
geriatric assessment
decision-making
geriatric oncology clinic
allied health
url https://www.mdpi.com/1718-7729/32/2/89
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