The effect of age and comorbidity on patient-centered health outcomes in patients receiving adjuvant chemotherapy for colon cancer

Hermosillo-Rodriguez, Jesus; Anaya, Daniel A.; Sada, Yvonne; Walder, Annette; Amspoker, Amber B.; Berger, David H.; Naik, Aanand D.

doi:10.1016/j.jgo.2012.12.004

Cited by 20 publications

(18 citation statements)

References 31 publications

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“…This is reflected by the literature to date (Ward et al, 2014, Soubeyran et al, 2012, Peel et al, 2013, Hermosillo-Rodriguez et al, 2013). However, lower ranked domains, such as psychological status are also important.…”

Section: Discussionmentioning

confidence: 92%

Expert consensus panel guidelines on geriatric assessment in oncology

2015

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Introduction Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes. The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme. Methods A four round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations in order to gain consensus on a given topic Results Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cutoff for assessment represented a higher degree of disagreement. Discussion The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients.

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Section: Discussionmentioning

confidence: 92%

Expert consensus panel guidelines on geriatric assessment in oncology

2015

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“…Three other studies examined this issue to some extent. Bajorek and Ren [45] and Hermosillo-Rodriguez et al [46] present some univariate data on patient refusal as a reason for non-receipt. Palmcrantz et al [47] present an interesting analysis that suggests there are age-related differences in expectations of recovery following stroke since disparities in the provision of health care between younger and older patients were not reflected in differences in self-perceived global recovery after 1 year.…”

Section: Resultsmentioning

confidence: 99%

Identifying inequitable healthcare in older people: systematic review of current research practice

Salway

Payne

Rimmer

et al. 2017

Int J Equity Health

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BackgroundThere is growing consensus on the importance of identifying age-related inequities in the receipt of public health and healthcare interventions, but concerns regarding conceptual and methodological rigour in this area of research. Establishing age inequity in receipt requires evidence of a difference that is not an artefact of poor measurement of need or receipt; is not warranted on the grounds of patient preference or clinical safety; and is judged to be unfair.MethodA systematic, thematic literature review was undertaken with the objective of characterising recent research approaches. Studies were eligible if the population was in a country within the Organisation for Economic Co-operation and Development and analyses included an explicit focus on age-related patterns of healthcare receipt including those 60 years or older. A structured extraction template was applied. Extracted material was synthesised in thematic memos. A set of categorical codes were then defined and applied to produce summary counts across key dimensions. This process was iterative to allow reconciliation of discrepancies and ensure reliability.ResultsForty nine studies met the eligibility criteria. A wide variety of concepts, terms and methodologies were used across these studies. Thirty five studies employed multivariable techniques to produce adjusted receipt-need ratios, though few clearly articulated their rationale, indicating the need for great conceptual clarity. Eighteen studies made reference to patient preference as a relevant consideration, but just one incorporated any kind of adjustment for this factor. Twenty five studies discussed effectiveness among older adults, with fourteen raising the possibility of differential effectiveness, and one differential cost-effectiveness, by age. Just three studies made explicit reference to the ethical nature of healthcare resource allocation by age. While many authors presented suitably cautious conclusions, some appeared to over-stretch their findings concluding that observed differences were ‘inequitable’. Limitations include possible biases in the retrieved material due to inconsistent database indexing and a focus on OECD country populations and studies with English titles.ConclusionsCaution is needed among clinicians and other evidence-users in accepting claims of healthcare ‘ageism’ in some published papers. Principles for improved research practice are proposed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-017-0605-z) contains supplementary material, which is available to authorized users.

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“…In a study by Hermosillo et al, old patients qualified for receiving the adjuvant chemotherapy in colorectal cancers didn't experience significant changes in their living conditions [9]. The outcomes of chemotherapy regarding the local recurrence and distant metastasis were similar for cancers of different locations.…”

Section: Discussionmentioning

confidence: 99%