Implementation and evaluation of a remote geriatric assessment and intervention program in Brazil

Abstract

AbstractBackgroundThis study sought to determine the feasibility and acceptability of a remote geriatric assessment (GA) and implementation (GAIN) program in Brazil. The authors also explored the effect of this program on health‐related quality of life (HR‐QOL) outcomes 3 months after initiating treatment.MethodsThis is a longitudinal study enrolling older adults (65+ years), diagnosed with any type of solid tumor, scheduled to initiate chemotherapy in a networked Brazilian cancer center. The GA was performed through telehealth. We assessed the feasibility of the remote GA, acceptability to patients, and changes in patient‐centered outcomes (HR‐QOL, mood, function) from baseline to month 3. Linear mixed model analysis was done, adjusting for age, gender, race, income, and disease stage.ResultsFifty‐six patients completed all intended assessments. Notably, the threshold of feasibility was 70% and there was 92% complete adherence. Average age was 76 years old (SD = 7.2). Most patients were female (57%), married (59%), and had a college degree (46%). The most common diagnoses were gastrointestinal (39%) and gynecological cancers (18%); most were diagnosed at an advance disease stage (77%). A total of 32 patients were referred to a remote appointment and 86% followed this recommendation(s). Significant improvement in Functional Assessment of Cancer Therapy ‐ General FACT‐G (mean difference, 6.04; p < .001), Geriatric Depression Scale (mean difference, −0.86; p = .008), and instrumental activities of daily living ratio (mean difference, 0.17; p < .001) were found.ConclusionRemote GAIN is feasible and acceptable to older adults with cancer receiving treatment in Brazil. The authors also found significant improvement in HR‐QOL outcomes over time. Notably, this GAIN program could guide early detection of chemotherapy toxicity and improving patient‐reported outcomes in low‐resource environments.