Implementing a Standardized Risk Model for Chemotherapy Adverse Events in Older Oncology Patients in a Community Cancer Center

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Publication Date

11-17-2016

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Advisor:

MR Cooper, Jefferson College of Population Health, Thomas Jefferson University

Abstract

As cancer is usually a disease of aging and the population of those over age 70 in the United States continues to increase, the ability to safely deliver systemic chemotherapy to geriatric oncology patients takes on more urgency. Selecting the appropriate patients to receive treatment, allowing for proper dosing and providing tailored support for patients who could potentially benefit from chemotherapy should improve the safety of treatment and the quality of life for senior oncology patients. This project has implemented a validated chemotherapy risk assessment program (CRASH) into the routine assessment of all oncology patients age 70 or older. Employing this procedure involved behavioral changes in nursing, physician, and pharmacy routines. Education and evaluation were incorporated into this project. The number of adverse events, supportive consultations with physical therapy, nutrition services, social work, and pharmacy were tracked. The assessment of polypharmacy, a common issue in the geriatric patient, was added to the evaluations. The initial intent of this program was to evaluate the ability to institute a validated tool for assessing geriatric oncology patients’ potential to tolerate chemotherapy in a community cancer center while expanding the knowledge and interest in the culture of safety it embodies. The project revealed a new outcome, the ability to identify and address geriatric issues to improve the safety of administration of medications and chemotherapy and tailoring interventions to the specific needs of each patient. Utilizing skills obtained from the coursework provided by the Jefferson College of Population Health, the Senior Oncology Program implemented at the Paoli Cancer Center enhanced safety for senior oncology patients treated at the center and became the new standard of care.

Presentation: 38:18

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