TY - JOUR
T1 - FARGO-360
T2 - a multi-disciplinary survey of practice and perspectives on provision of care for patients with frailty presenting with gynecological cancers in the UK and Ireland
AU - Audit and Research in Gynaecological Oncology (ARGO) Collaborative
AU - Wan, Yee-Loi Louise
AU - Cass, Gemma
AU - Collins, Anna
AU - Adishesh, Meera
AU - Addley, Susan
AU - Baker-Rand, Holly
AU - Bharathan, Rasiah
AU - Blake, Dominic
AU - Beirne, James
AU - Canavan, Lisa
AU - Dilley, James
AU - Fitzgibbon, Gary
AU - Glennon, Kate
AU - Ilenkovan, Narthana
AU - Jones, Eleanor
AU - Khan, Tabassum
AU - Madhuri, Thumuluru Kavitha
AU - McQueen, Victoria
AU - Montgomery, Alison
AU - O'Donnell, Rachel Louise
AU - Watmore, Sven
AU - White, Philip
AU - Owens, Gemma Louise
N1 - © IGCS and ESGO 2022. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - OBJECTIVES: Frailty has been associated with worse cancer-related outcomes for people with gynecological cancers. However, the lack of clear guidance on how to assess and modify frailty prior to instigating active treatments has the potential to lead to large variations in practice and outcomes. This study aimed to evaluate current practice and perspectives of healthcare practitioners on the provision of care for patients with frailty and a gynecological cancer.METHODS: Data were collected via a questionnaire-based survey distributed by the Audit and Research in Gynecological Oncology (ARGO) collaborative to healthcare professionals who identified as working with patients with gynecological malignancies in the United Kingdom (UK) or Ireland. Study data were collected using REDCap software hosted at the University of Manchester. Responses were collected over a 16 week period between January and April 2021.RESULTS: A total of 206 healthcare professionals (30 anesthetists (14.6%), 30 pre-operative nurses (14.6%), 51 surgeons (24.8%), 34 cancer specialist nurses (16.5%), 21 medical/clinical oncologists (10.2%), 25 physiotherapists/occupational therapists (12.1%) and 15 dieticians (7.3%)) completed the survey. The respondents worked at 19 hospital trusts across the UK and Ireland. Frailty scoring was not routinely performed in 63% of care settings, yet the majority of practitioners reported modifying their practice when providing and deciding on care for patients with frailty. Only 16% of organizations surveyed had a dedicated pathway for assessment and management of patients with frailty. A total of 37% of respondents reported access to prehabilitation services, 79% to enhanced recovery, and 27% to community rehabilitation teams.CONCLUSION: Practitioners from all groups surveyed considered that appropriate training, dedicated pathways for optimization, frailty specific performance indicators and evidence that frailty scoring had an impact on clinical outcomes and patient experience could all help to improve care for frail patients.
AB - OBJECTIVES: Frailty has been associated with worse cancer-related outcomes for people with gynecological cancers. However, the lack of clear guidance on how to assess and modify frailty prior to instigating active treatments has the potential to lead to large variations in practice and outcomes. This study aimed to evaluate current practice and perspectives of healthcare practitioners on the provision of care for patients with frailty and a gynecological cancer.METHODS: Data were collected via a questionnaire-based survey distributed by the Audit and Research in Gynecological Oncology (ARGO) collaborative to healthcare professionals who identified as working with patients with gynecological malignancies in the United Kingdom (UK) or Ireland. Study data were collected using REDCap software hosted at the University of Manchester. Responses were collected over a 16 week period between January and April 2021.RESULTS: A total of 206 healthcare professionals (30 anesthetists (14.6%), 30 pre-operative nurses (14.6%), 51 surgeons (24.8%), 34 cancer specialist nurses (16.5%), 21 medical/clinical oncologists (10.2%), 25 physiotherapists/occupational therapists (12.1%) and 15 dieticians (7.3%)) completed the survey. The respondents worked at 19 hospital trusts across the UK and Ireland. Frailty scoring was not routinely performed in 63% of care settings, yet the majority of practitioners reported modifying their practice when providing and deciding on care for patients with frailty. Only 16% of organizations surveyed had a dedicated pathway for assessment and management of patients with frailty. A total of 37% of respondents reported access to prehabilitation services, 79% to enhanced recovery, and 27% to community rehabilitation teams.CONCLUSION: Practitioners from all groups surveyed considered that appropriate training, dedicated pathways for optimization, frailty specific performance indicators and evidence that frailty scoring had an impact on clinical outcomes and patient experience could all help to improve care for frail patients.
KW - Anesthesia, General
KW - Genital Neoplasms, Female
KW - Preoperative Care
KW - Quality of Life (PRO)/Palliative Care
KW - Surgical Procedures, Operative
U2 - 10.1136/ijgc-2022-003396
DO - 10.1136/ijgc-2022-003396
M3 - Article
C2 - 35534018
SN - 1048-891X
VL - 32
SP - 924
EP - 930
JO - International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
JF - International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
IS - 7
ER -
