Geriatric oncology in the Netherlands: a survey of medical oncology specialists and oncology nursing specialists

Abstract

To identify ways to improve cancer care for older patients, we set out to examine how older patients in the Netherlands are currently being evaluated prior to oncological treatment and to explore the potential obstacles in the incorporation of a geriatric evaluation, using a web-based survey sent to Dutch medical oncology specialists and oncology nursing specialists. The response rate was 34% (183 out of 544). Two-thirds of respondents reported that a geriatric evaluation was being used, although primarily on an ad hoc basis only. Most respondents expressed a desire for a routine evaluation or more intensive collaboration with the geriatrician and 86% of respondents who were not using a geriatric evaluation expressed their interest to do so. The most important obstacles were a lack of time or personnel and insufficient availability of a geriatrician to perform the assessment. Thus, over 30% of oncology professionals in the Netherlands express an interest in geriatric oncology. Important obstacles to a routine implementation of a geriatric evaluation are a lack of time, or insufficient availability of geriatricians; this could be overcome with policies that acknowledge that quality cancer care for older patients requires the investment of time and personnel.

The G8 frailty screening tool and the decision‐making process in older breast cancer patients

“…This study has some limitations. et al, 2015;Ghignone et al, 2016;Jonker et al, 2014;Kenis et al, 2016). The results of this study therefore cannot simply be extrapolated to breast cancer patients in healthcare settings that are less geriatric oncology-minded.…”

“…Furthermore, this study is performed in a hospital where geriatric oncology is well embedded, with surgeons and oncologists who are well aware of the relevance of frailty in treatment decisions. Even though implementation of geriatric oncology is getting more attention across the globe, it still varies among different hospitals (Baitar et al, 2015; Ghignone et al, 2016; Jonker et al, 2014; Kenis et al, 2016). The results of this study therefore cannot simply be extrapolated to breast cancer patients in healthcare settings that are less geriatric oncology‐minded.…”

Geriatric consultation can aid in complex treatment decisions for elderly cancer patients

“…Indeed, it can be questioned whether it would not be better that such issues are discussed with someone specialised and experienced in treating cancer, particularly as many geriatricians indicate that oncology is currently not a priority for them (Jonker et al . ). We believe that investing additional time during oncological consultations to assess vulnerable elderly patients and explore their priorities will reduce both over‐ and undertreatment and we call on cancer specialists, policymakers and patients to work together to make this possible.…”

Implementation of geriatric assessment in oncology settings: A systematic realist review

“…The process of GA can therefore be streamlined and the challenges of the longitudinal care for the most frail and older adults can be improved (69,81) Policy Locally or nationally set cancer pathway targets can be relaxed or an exception agreed for older adults to be allowed time to undergo GA before decision-making. This eliminates one-size-fits-all pathway configurations, which can be more accommodating for older adults with cancer, and the pressure to meet targets in the context of complexity can be relieved (58,64,95) Information technology If systems can be developed (e.g. cybernetics, automation, and algorithms) so that implementation cost (e.g.…”