The purpose of this multi-phase research study is to understand how consultation of cancer care with a geriatrician can best improve outcomes for older adults with gastrointestinal malignancies.
Patients who are age 65+ at time of initial consult at DF/BWCC
Diagnosed with a gastrointestinal cancer, including: cancers of the esophagus, stomach, pancreas, liver, bile duct, ampulla, colon, rectum, or anus, as well as neuroendocrine tumors.
Continuing care at DF/BWCC beyond initial consult visit
Patients less than age 65 at time of initial consultation appointment with DF/BWCC.
Patients who are not continuing care at DF/BWCC beyond first consult visit.
Not proficient in English, Spanish, Haitian Creole, Portuguese, Traditional Chinese, Arabic, or Russian
Patient who are not considered appropriate for enrollment due to complex medical, social, or other situation as determined by their primary oncology team.
Single group
Phase 2 Intervention - Geriatric Co-Management
Other interventionParticipants will complete an electronic fitness assessment questionnaire - once completed, they will receive a score of "Robust", "Pre-Frail" or "Frail". Those who are "Pre-frail" or "Frail" will be randomized to meet with a study geriatrician for geriatric co-management in addition to usual oncology care. All participants will be followed for a duration of 1 year.
Feasibility of electronic fitness assessment questionnaire (developed from Comprehensive Geriatric Assessment tool)
EFA questionnaire deployed to older adult patients age 70+ in the REACH study. Feasibility will be determined by the proportion of participants who consent to complete the electronic fitness assessment. The intervention will be considered feasible if 70% of participants consent to complete the fitness assessment.
Acceptability of electronic fitness assessment questionnaire
Acceptability of electronic fitness assessment questionnaire via the Patient Portal or internet-enabled device following second clinic visit among older adults diagnosed with gastrointestinal cancer seeking consultation at DF/BWCC for medical, radiation, or surgical oncology. Acceptability will be determined by the proportion of participants who fully complete the EFA. The intervention will be considered acceptable if 60% of enrolled participants fully complete the EFA within 14 days of enrollment.
Association of geriatric consultation with number of unplanned ED visits/hospitalizations among older adult participants
Association of geriatrician consult with number of ED visits/hospitalizations among older adults diagnosed with gastrointestinal cancer randomized to the geriatric consultation intervention. Randomization will be essential to evaluate the efficacy of geriatric consultation intervention in impacting unplanned ED visits and hospitalizations.
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