Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Implementation and Evaluation of a Nurse-Led Geriatric Oncology Model of Care in lung cancer (125614)

Shalini K Vinod 1 2 3 , Nicole Knox 3 , Katie Knight 2 , Victoria Bray 2 4 , Angela Khoo 5 , Elise Tcharkhedian 6 , Josephine Campisi 7 , Polly Dufton 8 , Gemma McErlean 3 9 , Meera Agar 2 3 10 11 , Louise Hickman 3
  1. South West Sydney Clinical Campuses, University of New South Wales, Liverpool, New South Wales, Australia
  2. Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW, Australia
  3. Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia
  4. School of Medicine, Western Sydney University, Penrith, NSW, Australia
  5. Brellah Medical Group, Sydney, NSW, Australia
  6. Physiotherapy Department, Liverpool Hospital, Liverpool, NSW, Australia
  7. Occupational Therapy Department, Liverpool Hospital, Liverpool, NSW, Australia
  8. Department of Medical Oncology, Austin Health, Melbourne, NSW, Australia
  9. St George Hospital, Kogarah, NSW, Australia
  10. IMPACCT Faculty of Health, University of Technology , Sydney, NSW, Australia
  11. South Western Sydney Clinical School, University of NSW, Liverpool, NSW, Australia

Background

Older adults living with lung cancer (median age 72 years) often present with multiple comorbidities complicating treatment decisions. Despite clear evidence that targeted geriatric screening and assessment improves outcomes; it is underutilised in clinical practice. The aim of this study was to codesign, implement and evaluate a nurse-led geriatric oncology model of care (NL-GOMOC) for older people with lung cancer.  

Methods

A NL-GOMOC was codesigned with input from consumers. People with a new diagnosis of lung cancer aged 65+ years or 50+ years if Aboriginal or Torres Strait Islander were eligible. Clinic lists were screened to identify eligible patients. Participants underwent a one-hour assessment using validated tools usually immediately before or after the oncology appointment. Specific triggers resulted in referral to allied health staff or geriatric assessment in a multidisciplinary clinic. Data was collected on patient assessments, issues and referrals.

Impact on Practice

From June 2023 – May 2024, 168 patients were screened,113 were eligible and 100 (88%) were seen. Pre-frailty/frailty was identified in 70% based on G8 score and 40% based on the clinical frailty scale. The most common issues identified were nutrition (62%), polypharmacy (40%), depression (18%) and mobility (17%). 78% of patients were referred to at least one allied health service and 25% were referred for a combined assessment in a multidisciplinary clinic. Treatment de-escalation occurred in 3%.

Discussion

NL-GOMOC enabled context-sensitive care aligned with existing services. Identification of unmet needs enabled timely referrals to supportive care services and recognition of those who would benefit from multidisciplinary input. This pragmatic, nurse-led model demonstrates feasibility and value in delivering person-centered management and increasing access to geriatric assessment. It should be integrated into routine practice for older adults with cancer.