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. 2023 Jul 1;129(13):2095-2102.
doi: 10.1002/cncr.34759. Epub 2023 Mar 25.

Implementation and evaluation of a remote geriatric assessment and intervention program in Brazil

Cristiane Decat Bergerot  1 , Paulo Gustavo Bergerot  1 , Marianne Razavi  2 , Errol J Philip  3 , Sabri Lakhdari  4 , Marcos Vinicius da Silva França  1 , Lorena Nascimento Manrique Molina  1 , Alici Natalia de Sousa Freitas  1 , Mariane Cunha Taveira  1 , Andressa Cardoso de Azeredo  5 , William Hiromi Fuzita  6 , Cristiano Menezes Fernandes  1 , Raquel Batista Pio  1 , Romildo de Araujo  7 , Milena Macedo Couto  1 , Vitor Fiorin de Vasconcellos  8 , Maria Fernanda Nonino  1 , David Lee  9 , João Nunes de Matos Neto  1 , Marco Murilo Buso  1 , Enrique Soto-Perez-de-Celis  10 , William Dale  2
Affiliations
Free article

Implementation and evaluation of a remote geriatric assessment and intervention program in Brazil

Cristiane Decat Bergerot et al. Cancer. .
Free article

Abstract

Background: This study sought to determine the feasibility and acceptability of a remote geriatric assessment (GA) and implementation (GAIN) program in Brazil. The authors also explored the effect of this program on health-related quality of life (HR-QOL) outcomes 3 months after initiating treatment.

Methods: This is a longitudinal study enrolling older adults (65+ years), diagnosed with any type of solid tumor, scheduled to initiate chemotherapy in a networked Brazilian cancer center. The GA was performed through telehealth. We assessed the feasibility of the remote GA, acceptability to patients, and changes in patient-centered outcomes (HR-QOL, mood, function) from baseline to month 3. Linear mixed model analysis was done, adjusting for age, gender, race, income, and disease stage.

Results: Fifty-six patients completed all intended assessments. Notably, the threshold of feasibility was 70% and there was 92% complete adherence. Average age was 76 years old (SD = 7.2). Most patients were female (57%), married (59%), and had a college degree (46%). The most common diagnoses were gastrointestinal (39%) and gynecological cancers (18%); most were diagnosed at an advance disease stage (77%). A total of 32 patients were referred to a remote appointment and 86% followed this recommendation(s). Significant improvement in Functional Assessment of Cancer Therapy - General FACT-G (mean difference, 6.04; p < .001), Geriatric Depression Scale (mean difference, -0.86; p = .008), and instrumental activities of daily living ratio (mean difference, 0.17; p < .001) were found.

Conclusion: Remote GAIN is feasible and acceptable to older adults with cancer receiving treatment in Brazil. The authors also found significant improvement in HR-QOL outcomes over time. Notably, this GAIN program could guide early detection of chemotherapy toxicity and improving patient-reported outcomes in low-resource environments.

Keywords: feasibility study; geriatric assessment; health-related quality of life; physical function; symptoms of depression.

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References

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