Patient-Centered Care for the Older Adult With Hematologic Malignancy

This research study is evaluating if co-management by a geriatrician embedded in the oncology clinic can improve outcomes for frail older adults with blood cancers. A rigorous pre-entry frailty assessment by a trained research assistant will be followed by randomization to geriatrician co-management versus usual care for patients found to be frail or pre-frail.

Older adults have unique health concerns, and in particular, older adults with blood cancers may have different disease and other health related issues than younger adults with similar diagnoses. One aspect of aging which can make older adults more vulnerable is frailty. Frailty is a general term that describes a decline in multiple areas of health, including the loss of energy, physical ability, and mental ability. Frailty can make it difficult for patients with cancer to respond to treatment and more likely to have side effects. On the other hand, many older patients are not frail despite advanced age. This study is being done to determine if co-management by a geriatrician of older adults who are found to be frail through a detailed baseline assessment can improve outcomes.

All patients receive baseline geriatric screening/assessment by a research assistant to determine frailty status.

A board-certified geriatrician embedded in the oncology clinic will co-manage patients randomized to this arm.

Inclusion Criteria: All patients aged 75 and older who present for an initial consultation at the Dana-Farber/Brigham and Women's Cancer Center for hematologic malignancy (transplantation consultation excluded). Assessed to be pre-frail or frail on formal baseline geriatric assessment. Exclusion Criteria: Not willing to participate

Randomized controlled trial of geriatric consultation versus standard care in older adults with hematologic malignancies