Assessment methods and services for older people with cancer in the United Kingdom

Table 1 Background of respondents

Specialty	n (%)
Clinical oncology	135 (21.3)
Medical oncology	164 (25.8)
Cancer services/oncology other	93 (14.6)
Acute oncology	30 (4.7)
Haem-oncology	54 (8.5)
Surgery	49 (7.7)
Geriatrics/elderly care	61 (9.6)
Palliative care	23 (3.6)
Other	26 (4.1)
Discipline
Doctor	332 (52.0)
Nurse	251 (39.3)
Physiotherapist/occupational therapist	34 (5.3)
Other	21 (3.3)
Tumour group
All	241 (37.7)
Tumour specific	350 (54.7)
Not applicable	36 (5.6)

Represents percentage of those who responded excluding non-response.

Table 2 Health professionals involved in the assessment of older people presenting to cancer service (%)

Health professional	Always	Often	Sometimes	Rarely	Never	Don't know
Oncologist	51.4 (298/580)	36.9 (214/580)	7.1 (41/580)	2.2 (13/580)	1.6 (9/580)	0.1 (5/580)
Surgeon	19.4 (106/545)	34.1 (186/545)	34.3 (187/545)	5.1 (28/545)	3.5 (19/545)	3.5 (19/545)
Geriatrician	4.7 (25/531)	9.4 (50/531)	24.7 (131/531)	32.6 (173/531)	21.1 (112/531)	7.5 (40/531)
Nurse	59.3 (343/578)	30.1 (174/578)	5.9 (34/578)	1.4 (8/578)	1.4 (8/578)	1.9 (11/578)
Physiotherapist	7.6 (42/556)	28.2 (157/556)	36.3 (202/556)	15.8 (88/556)	5.8 (32/556)	6.3 (35//556)
Occupational therapist	6.1 (34/553)	28.9 (160/553)	33.5 (185/553)	19.0 (105/553)	6.1 (34/553)	6.3 (35/553)
Dietician	4.7 (26/554)	29.1 (161/554)	42.1 (233/554)	13.4 (74/554)	5.6 (31/554)	5.2 (29/554)
Social worker	2.9 (16/550)	19.1 (105/550)	41.6 (229/550)	19.8 (109/550)	8.9 (49/550)	7.6 (42/550)
Pharmacist	23.8 (131/550)	24.4 (134/550)	19.6 (108/550)	17.1 (94/550)	9.6 (53/550)	5.5 (30/550)
General practitioner	26.6 (143/538)	25.5 (137/538)	18.8 (101/538)	11.3 (61/538)	7.8 (42/538)	10.0 (54/538)

Table 3 Assessment methods currently used (%)

	Used	Not used	Don't know
Assessment method
Clinical history	98.5 (572/581)	1.0 (6/581)	0.5 (3/581)
Performance status	90.2 (513/569)	7.7 (44/569)	2.1 (12/569)
Scores	33.8 (179/529)	53.1 (281/529)	13.0 (69/529)
Local methods	13.7 (64/467)	69.0 (322/467)	17.3 (81/467)
Structured assessment and/or assessment tool used to assess
Comorbidity	62.2 (345/555)	31.2 (173/555)	6.7 (37/555)
Medications	60.1 (333/554)	33.2 (184/554)	6.7 (37/554)
Frailty	46.8 (257/549)	44.3 (243/549)	8.9 (49/549)
Mobility	61.1 (337/552)	34.2 (189/552)	4.7 (26/552)
Falls	51.9 (285/549)	42.8 (235/549)	5.3 (29/549)
Function	65.0 (358/551)	30.5 (168/551)	4.5 (25/551)
Nutrition	58.5 (321/549)	35.2 (193/549)	6.4 (35/549)
Quality of life	52.8 (290/549)	40.1 (220/549)	7.1 (39/549)
Cognition	60.5 (329/544)	31.8 (173/544)	7.7 (42/544)
Mood	46.9 (254/542)	43.0 (233/542)	10.1 (55/542)
Social circumstances	57.2 (313/547)	36.2 (198/547)	6.6 (36/547)

Represents percentage of those who responded excluding non-response.

Table 4 Specific tools used or would consider to use, % (n)

	Used	Would consider to use but currently do not use
ASA score	10.5 (67)	3.9 (25)
POSSUM score	5.9 (38)	4.7 (30)
G8 score	1.7 (11)	9.2 (59)
VES13	0.6 (4)	5.2 (33)
ACE27	4.8 (31)	8.1 (52)
CCI	6.7 (43)	12.8 (82)
Number of comorbidities	19.4 (124)
Barthel’s index of ADLs	15.0 (96)	12.0 (77)
iADLs	15.2 (97)	8.6 (55)
AMT score	27.3 (175)	6.1 (39)
MMSE	36.7 (235)	7.7 (49)
MoCA	7.5 (48)	3.9 (25)
GDS	6.9 (44)	13.6 (87)
HADS	20.2 (129)	8.9 (57)
PHQ9	2.5 (16)	9.1 (58)
MUST	32.8 (210)	8.3 (53)
BMI	56.1 (359)	5.8 (37)
EFS	3.8 (24)	13.1 (84)
GFI	0.0 (1)	8.4 (54)
Rockwood pictorial frailty scale	1.4 (9)	8.8 (56)
HNA	44.8 (287)	11.3 (72)
EORTC QLQ-C30	9.8 (63)	11.4 (73)
CGA-GOLD questionnaire	Not asked as not well known	8.1 (52)

Percentage of all participants. ASA: American Society of Anaesthesiologists; POSSUM: Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity; G8: Geriatric 8; VES13: Vulnerable Elders Survey; ACE27: Adult Comorbidity Evaluation 27; CCI: Charlson Comorbidity Index; ADLs: Activities of Daily Living; iADLs: Instrumental Activities of Daily Living; AMT: Abbreviated Mental Test; MMSE: Mini Mental State Examination; MoCA: Montreal Cognitive Assessment; GDS: Geriatric Depression Scale; HADS: Hospital Anxiety and Depression Scale; PHQ9: Patient Health Questionnaire–9; MUST: Malnutrition Universal Screening Tool; BMI: Body Mass Index; EFS: Edmonton Frailty Scale; GFI: Groningen Frailty Indicator; HNA: Holistic Needs Assessment; EORTC QLQ-C30: European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30; CGA-GOLD: Comprehensive Geriatric Assessment – Geriatric Oncology Liaison Development.

Table 5 Multi-disciplinary access (%)

Health professional	Urgent access	Routine access	No access	Don't know
Geriatrician	24.8 (118/475)	48.0 (228/475)	19.4 (92/475)	7.8 (37/475)
Medical physician	41.3 (191/462)	37.2 (172/462)	16.2 (75/462)	5.2 (24/462)
Single organ specialists	43.6 (203/466)	44.2 (206/466)	7.5 (35/466)	4.7 (22/466)
General practitioners	39.9 (188/471)	49.5 (233/471)	7.2 (34/471)	3.4 (16/471)
Physiotherapists	42.9 (204/476)	47.1 (224/476)	5.9 (28/476)	4.2 (20/476)
Occupational therapists	37.2 (178/479)	52.0 (249/479)	6.1 (29/479)	4.8 (23/479)
Dietician	38.9 (186/478)	54.0 (258/478)	4.2 (20/478)	2.9 (14/478)
Social workers	24.7 (116/470)	58.9 (277/470)	9.8 (46/470)	6.6 (31/470)
Psychological	26.5 (126/475)	56.8 (270/475)	11.8 (56/475)	4.9 (23/475)
Older peoples nurse	17.3 (82/473)	31.3 (148/473)	33.6 (159/473)	17.8 (84/473)
Psychiatry	16.5 (78/473)	47.1 (223/473)	21.8 (103/473)	14.6 (69/473)
Palliative care	78.7 (377/479)	19.2 (92/479)	0.6 (3/479)	1.5 (7/479)