A Patient-Oriented Research Program in Geriatric Oncology

以患者为中心的老年肿瘤学研究项目

• 批准号: 10370333
• 负责人: Supriya G. Mohile
• 金额: $ 17.21万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-04-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10370333
• 关键词: Adjuvant Chemotherapy; Advanced Malignant Neoplasm; Affect; Aging; Area; Assessment tool; Audiotape; Award; Benefits and Risks; Cancer Prognosis; Caregivers; Caring; Clinic; Clinical; Clinical Oncology; Cognitive; Communication; Communication Research; Communities; Community Clinical Oncology Program; Complex; Conflict (Psychology); Contracts; Data; Data Analyses; Data Set; Decision Making; Elderly; Enrollment; Frail Elderly; Funding; Geriatric Assessment; Geriatrics; Goals; Growth; Health; Health Status; Impairment; Intervention; Investigation; Knowledge; Leadership; Malignant Neoplasms; Mediating; Mentors; Modeling; Morbidity - disease rate; Oncologist; Oncology; Outcome; Palliative Care; Patient-Focused Outcomes; Patients; Performance Status; Phase; Positioning Attribute; Principal Investigator; Process; Prognosis; Randomized; Randomized Clinical Trials; Regimen; Research; Research Institute; Risk; Site; Symptoms; Toxic effect; Toxicity due to chemotherapy; Training; Uncertainty; Universities; Work; adverse outcome; age related; cancer care; cancer clinical trial; cancer therapy; care delivery; career; career development; chemotherapy; clinical encounter; clinical trial implementation; design; improved; improved outcome; innovation; innovative technologies; insight; intervention effect; mortality; novel; older patient; oncology program; patient oriented; patient oriented research; programs; research and development; research study; routine care; secondary analysis; skills; tool; treatment risk

PROJECT SUMMARY: Over 60% of cancers occur in older persons, and the number of patients with cancer is expected to grow. Geriatric assessment (GA), a validated patient-centered approach for assessing health status, can identify older patients with cancer who are at risk of adverse outcomes. The majority of oncologists have not adopted GA, largely because of lack of knowledge on how to utilize GA to guide communication and decision-making. Two multicenter cluster randomized studies in the University of Rochester (UR) NCI Community Oncology Research Program (NCORP) led by the Principal Investigator (PI) are evaluating if a GA intervention can improve communication about age-related issues (funded by a Patient Centered Outcomes Research Institute contract) and reduce toxicity from cancer treatment (funded by a NCI R01) through improved decision- making. Our preliminary data illustrates that: 1) age-related concerns and symptom burden are not addressed effectively in oncology clinical encounters; 2) community oncologists often provide chemotherapy to frail older adults with serious consequences; 3) a significant proportion of older patients with advanced cancer undergoing treatment and their caregivers believe the cancer will be cured; and 4) the majority of older patients would choose to forgo cancer treatment if they knew there would be serious functional and/or cognitive consequences. The current proposal builds on the PI's geriatric oncology program by developing new patient-oriented research and providing opportunities for mentees in this underrepresented area. The PI, a geriatric oncologist, and the research team including experts in communication, palliative care, caregiver and geriatric oncology research are well positioned to complete the aims of this proposal. The overarching aims are to: 1) develop insight into how to improve communication between older patients with cancer, their oncologists, and their caregivers about age-related concerns and symptoms, the risks and benefits of treatment, and prognosis through secondary analyses of data from the PI's multi-site studies and 2) develop and implement an intervention to integrate GA into oncology care to improve communication about the risks and benefits of chemotherapy for older patients. With support of this K24, the PI will complete specific career development activities that will enhance her skills in communication research and for mentoring and leadership. With regard to expected outcomes, this proposal will fill vital gaps in knowledge regarding the mechanisms of how GA can improve communication and outcomes. This research will have a positive impact by providing a pragmatic mechanism for incorporating GA into community oncology clinics to improve outcomes of older adults with cancer through more effective communication. This K24 will allow the PI to bridge the fields of geriatric oncology and communication research by bringing together an interdisciplinary team of experts and geriatric oncology mentees through novel analyses of existing data from funded clinical trials and the implementation of a new project.

项目摘要： 超过60％的癌症发生在老年人中，预计癌症患者的数量将增加。 老年评估（GA）是一种以患者为中心的评估健康状况的方法，可以识别 患有不良后果风险的癌症患者。大多数肿瘤学家没有采用 GA，很大程度上是由于缺乏有关如何利用GA来指导沟通和决策的知识。 罗切斯特大学（UR）NCI社区肿瘤学的两个多中心群集随机研究 首席研究员（PI）领导的研究计划（NCORP）正在评估GA干预是否可以 改善与年龄有关的问题的沟通（由患者以患者为中心的结果资助 研究所合同）并通过改善决策来减少癌症治疗（由NCI R01资助）的毒性 - 制作。我们的初步数据说明：1）与年龄有关的问题和症状负担不是 有效地在肿瘤学临床遭遇中解决； 2）社区肿瘤学家经常为 脆弱的老年人会造成严重后果； 3）大部分老年患者患有晚期癌症 接受治疗及其护理人员认为癌症将被治愈； 4）大多数老年患者 如果他们知道会有严重的功能和/或认知能力，他们会选择放弃癌症治疗 结果。当前的提案通过开发新的新的PI的老年肿瘤学计划建立 面向患者的研究并为这一代表性不足的领域提供了受训者的机会。这 PI，老年肿瘤学家和研究团队，包括传播专家，姑息治疗，照料者 老年肿瘤学研究良好，可以完成该提案的目标。总体 目的是：1）对如何改善老年癌症患者之间的沟通，他们的洞察力发展 肿瘤学家及其对年龄有关的关注和症状的照顾者，风险和好处 通过对PI的多站点研究的数据进行二次分析的处理和预后2） 并实施一项干预措施，将GA纳入肿瘤学护理以改善有关风险的沟通 化学疗法对老年患者的好处。在此K24的支持下，PI将完成特定的职业 开发活动将增强她在沟通研究和指导和指导方面的技能 领导。关于预期的结果，该提案将填补有关该知识的重要空白 GA如何改善沟通和结果的机制。这项研究将产生积极的影响 通过提供一种务实的机制，将GA纳入社区肿瘤学诊所以改进 通过更有效的沟通，老年人患有癌症的结果。这个K24将允许PI 通过将一个结合在一起的老年肿瘤学和传播研究领域 通过对现有的新分析，专家和老年肿瘤学指导者的跨学科团队 来自资助的临床试验的数据和新项目的实施。