The implementation and evaluation of a geriatric cancer care module for older patients with colorectal carcinoma.

The implementation of care pathways improves care so that the organizition of
care is more effective, reduces lead times and an increased patient
satisfaction. Because of age related problems and multimorbidity there are
often changes needed in the usual cancer pathways in the care of older cancer
patients. In this study a geriatric oncology module will be implemented and
evaluated within the already existing pathway colorectal cancer for patients
aged 70 years or older in 10 Dutch hospitals.

This study examines the effect of systematic geriatic screening, via a
geriatric oncology care module and geriatric interventions, on the quality of
life of patients aged 70 years or older with colorectal carcinoma. We also
examine whether systematic geriatric screening affects the satisfaction with
care, the self-reliance, the number of unplanned hospitalizations, 12 month
survival and the living situation of the patient.

A population-based longitudinal study.

In this study the standard care for ouder patients with colorectal cancer will
be compared to the standard care with attention to geriatric screening. The
geriatric screening consists of several validated questionnaires and a brief
physical test. 5 hospitals will start immediately with the geriatric oncology
care pathway, the 5 other hospitals will initially serve as a control group and
start with the geriatric oncology care pathway at 6 months.

A geriatric screening wil be administered from patients who are eligible for
participation in this study. This screening consists of several validated
questionnaires and a brief physical test. The estimated time to administer this
screening is about 45 minutes. The geriatric screening may be followed by
additional assessments or interventions. In addition, all patients are asked to
fill in questionnaires regarding self-reliance, satisfaction with care,
self-management, and quality of life.
All patients recieve standard cancer care with special attention to age-related
problems. Geriatric screening has proven its importance in detecting hidden
geriatric problems and leads to additional interventions and treatment. In
addition, at an early stage in the process there is a focus on identifying the
strengths and weaknesses of the patient.
The administration of geriatric screening and completing the questionnaires
takes extra time. Completing the questionnaires can be though mentally as the
questions can be seen as personal or confrontational.