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Prof Supriya Gupta Mohile: Improving Care Delivery for Older Patients with Cancer through Fostering Communication about Age-Related Concerns

Organized by Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology

Jun
29
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00
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4
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Location:

Heydon Laurence LT, the University of Sydney

You are invited to an international guest presentation this Friday 29 June at 3pm in Heydon Laurence Lecture Theatre organized by Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology. Prof Supriya Mohile will be speaking on her program of work which aims to improve cancer care for older patients by fostering communication. This will include data from her oral presentation at the recent American Society of Clinical Oncology (ASC) meeting held in Chicago.

Speaker: Prof Supriya Gupta Mohile, MD, MS

Title: Improving Care Delivery for Older Patients with Cancer through Fostering Communication about Age-Related Concerns

Abstract: Background: GA includes validated measures that assess age-related health domains (e.g., function, cognition) known to increase adverse outcomes. In this PCORI and NCI funded CRCT, we evaluated if providing a GA summary and recommendations for GA-guided interventions improves communication about age-related concerns for older patients (pts) with cancer. Methods: Pts aged ≥ 70 with advanced solid tumors or lymphoma and at least 1 impaired GA domain were enrolled. Oncology practices were randomized to intervention (oncologists received GA summary) or usual care (no summary provided). The primary outcomes were: 1) number of discussions about age-related concerns (the clinic visit after GA was audio-recorded and transcribed; 2 blinded coders evaluated quality of communication and plan for follow-up interventions) and 2) telephone surveys of patient satisfaction (modified Health Care Climate Questionnaire [HCCQ-age] scored 7-35). Outcomes were analyzed using linear mixed models with arm as the fixed effect, controlling for practice.Results: From 2014-17, 544 pts (295 in GA) were enrolled from 31 practices. There were no differences in demographics by arm (mean age 77 yrs; 49% female). More patients in usual care had impaired physical performance (96% vs 92%, p = 0.03) and social support (33% vs 25%, p = 0.05). In 530 evaluable pts, the overall mean number of discussions was 6.3 (SD: 4.0). The GA arm had 3.5 more discussions about age-related concerns (95%CI: 2.28-4.72, p = 10-6; intraclass correlation coefficient [ICC] = 0.24) compared to usual care; of these, in the GA arm, 2.0 more discussions on average had higher quality communication (95%CI: 1.20-2.69; p = 6x10-6) and 1.9 more led to interventions (95% CI: 1.14-2.73; p = 1.6x10-5). The GA arm had significantly more discussions for almost all GA domains. In 511 pts with HCCQ-age, the mean score was 22.9 (SD 4.5); the score was 1.12 points higher in the GA arm (95%CI: 0.23-2.03; p = .027; ICC = 0.02). Conclusions: Providing a GA summary to oncologists increases the number and quality of discussions about age-related concerns and improves pt satisfaction. Clinical trial information: NCT02107443.

Biography: Supriya Gupta Mohile, MD, MS, is a Professor of Medicine in the Division of Hematology/Oncology at the University of Rochester Medical Center. A board-certified geriatrician and medical oncologist with clinical expertise in gastrointestinal and genitourinary cancers, Dr. Mohile's research interests include the evaluation of patterns of care, health outcomes, and quality of life related to cancer treatment in older patients. In 2013, she was awarded a Patient Centered Outcomes Research Institute Award and an NCI R01 to evaluate whether geriatric assessment can improve outcomes of older patients with cancer. She directs the Specialized Oncology Care & Research in the Elderly geriatric oncology clinic at the University of Rochester/Highland Hospital and is an integral member of the University of Rochester NCI Community Oncology Research Program Research Base which is directed by Dr. Gary Morrow. She currently is on the editorial board of the Journal of Clinical Oncology, is Editor in Chief of the Journal of Geriatric Oncology, and she previously served as Chair of the ASCO Geriatric Oncology Course Planning Committee. Supriya was awarded the B.J Kennedy Award for Excellence in Geriatric Oncology at the American Society of Clinical Oncology in June 2018.