How to Implement a Geriatric Assessment in Your Clinical Practice
How to Implement a Geriatric Assessment in Your Clinical Practice
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DOI：
10.1634/theoncologist.2014-0180
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发表时间：
2014-10-01
期刊：
影响因子：
5.8
通讯作者：
Puts, Martine T. E.
中科院分区：
文献类型：
--
作者：
Sattar, Schroder;Alibhai, Shabbirm. H.;Puts, Martine T. E.
癌症是一种主要影响老年人的疾病。其他健康状况，功能状态的变化以及多种药物的使用改变了老年人癌症治疗的风险和益处。一些国际组织，如国际老年肿瘤学会，欧洲癌症研究和治疗组织，建议对患有癌症的老年人进行老年评估（GA），以帮助选择最合适的治疗方法，并确定任何可能干扰治疗的潜在未检测到的医学，功能和心理社会问题。这篇综述的目的是描述什么是GA，以及如何在肿瘤学环境中将其应用于老年癌症患者的日常临床实践。我们提供了常用工具的概述。执行GA的关键考虑因素包括可用资源（人员，空间和时间），患者人群（将被评估），使用什么GA工具和临床随访（谁将负责使用GA结果制定护理计划以及谁将提供随访护理）。在临床实践中实施GA的重要挑战包括无法轻松及时地获得老年医学专业知识，额外医院就诊的患者负担，以及GA团队和肿瘤学家之间就GA转诊人群的期望和GA的预期结果建立合作。最后，我们为GA过程中发现的问题提供了一些可能的干预措施。
Cancer is a disease that mostly affects older adults. Other health conditions, changes in functional status, and use of multiple medications change the risks and benefits of cancer treatment for older adults. Several international organizations, such as the International Society of Geriatric Oncology, the European Organization for Research and Treatment of Cancer, recommend the conduct of a geriatric assessment (GA) for older adults with cancer to help select the most appropriate treatment and identify any underlying undetected medical, functional, and psychosocial issues that can interfere with treatment. The aim of this review is to describe what a GA is and how to implement it in daily clinical practice for older adults with cancer in the oncology setting. We provide an overview of commonly used tools. Key considerations in performing the GA include the resources available (staff, space, and time), patient population (who will be assessed), what GA tools to use, and clinical follow-up (who will be responsible for using the GA results for developing care plans and who will provide follow-up care). Important challenges in implementing GA in clinical practice include not having easy and timely access to geriatric expertise, patient burden of the additional hospital visits, and establishing collaboration between the GA team and oncologists regarding expectations of the population referred for GA and expected outcomes of the GA. Finally, we provide some possible interventions for problems identified during the GA.