Impact of care pathway for nursing home residents treated for cancer: ONCO-EHPAD study.

TitreImpact of care pathway for nursing home residents treated for cancer: ONCO-EHPAD study.
Publication TypeJournal Article
Year of Publication2021
AuthorsCouderc A-L, Berbis J, Delalande G, Mugnier B, Courcier A, Bourriquen M, Rey D, Greillier L, Baciuchka M, Sudour P, Agnelli L, Nouguerède E, Fabries S, Villani P
JournalSupport Care Cancer
Date Published2021 Jul
Mots-clésAged, Aged, 80 and over, Female, Geriatric Assessment, Humans, Male, Neoplasms, Nursing Homes, Patient Care Planning, Prospective Studies, Quality of Life

PURPOSE: Few data are known about cancer management in frail nursing home residents.METHODS: Objective of our prospective, interventional study was to set up in the Marseille area, a care pathway for nursing homes residents with a suspected cancer. It combined cancer diagnosis procedures and comprehensive geriatric assessment (CGA), both made in our geriatric oncology outpatient unit, before oncologic advice for treatment decision. In standard care, CGA is carried out after therapeutic decision, to determine whether the planned treatment is compatible with the patient's frailties. CGA and quality of life were performed at enrolment and at 6 months. This study was registered in (NCT03103659).RESULTS: Between April 2017 and March 2020, 48 residents from 38 nursing homes were included: 24 had the care pathway (PP), and 24 the standard care (NPP). Six were excluded (no cancer). PP had more frailties than NPP. All PP and 75% of NPP had outpatient care. Curative treatment was given to 77% of NPP (including chemotherapy in 10 cases), and 25% of PP (surgery, radiotherapy, hormone therapy). A majority of PP (75%) had supportive care. At 6 months, 16 patients died (11 NPP, 5 PP). Quality of life evolution was available for 11 PP and 7NPP: it showed stability in PP and degradation in NPP.CONCLUSION: Even if part of residents were too frail to get curative treatment, the care pathway enabled them to benefit from oncologic advice and appropriate supportive care while preserving their quality of life. Further investigations are needed to confirm these findings.

Alternate JournalSupport Care Cancer
PubMed ID33392770
Grant ListAP-IPSA-15-007 / / Fondation de l'Avenir pour la Recherche Médicale Appliquée /