Assessment of frailty in lung cancer patients: is there concordance between lung cancer clinical nurse specialists (LCNS) and oncologists?
Eaton, Marie A Neal, Hilary McEntee, Delyth Bostock, Layla Halkyard, Emma Bayman, Neil A Blackhall, Fiona H Fenemore, Jackie Gomes, Fabio
Eaton, Marie A
Neal, Hilary
McEntee, Delyth
Bostock, Layla
Halkyard, Emma
Bayman, Neil A
Blackhall, Fiona H
Fenemore, Jackie
Gomes, Fabio
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Abstract
Introduction: The treatment landscape for lung cancer patients is
rapidly evolving with multiple lines and combinations available. With
an aging population, identifying and managing frailty is increasingly
important. The Rockwood Clinical Frailty Scale (CFS) was introduced
at this tertiary cancer centre in November 2018 to assess lung cancer
patients at first appointment. The aim of this audit was to assess
concordance of CFS scoring between oncologists and the LCNS.
Methods: New lung cancer patients at this centre are routinely
assessed by both oncologist and LCNS and their fitness level
evaluation routinely includes the Rockwood CFS (1–8 scale). CFS
1–3 is considered fit and 4–8 vulnerable/frail. Over two months, the
LCNS team independently scored each new patient and results were
compared with the scores from oncologists.
Results: The concordance rate between oncologists and LCNS was
31% of the 45 patients included. In 74% of cases, the LCNS assessed
the patient as more frail with the mean CFS score for oncologists
being 3.6 and 4.1 for LCNS (p=0.01). For those classed by oncologists
as ‘vulnerable/frail’ there was no significant difference in the mean
scores when compared with LCNS (4.9 and 5.1, respectively). For
those classed by oncologists as ‘fit’ the mean score was significantly
higher (more frail) when assessed by the LCNS (2.6 and 3.7; p=0.001).
Patients receiving systemic treatment and classed as ‘fit’ by the LCNS
had an admission rate of 33%, hotline use of 56% and an average 7
contacts with LCNS. Patients classed as ‘fit’ by the Clinicians had an
admission rate of 47%, hotline use of 68% and an average 6 contacts
with LCNS.
Conclusion: LCNS identify a higher proportion of frail patients,
particularly patients with a borderline fitness level. These results
will be used in developing a triage tool for the LCNS service.
Affiliation
Description
Date
2020
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Eaton MA, Neal H, McEntee D, Bostock L, Halkyard E, Bayman NA, et al. Assessment of frailty in lung cancer patients: is there concordance between lung cancer clinical nurse specialists (LCNS) and oncologists? Lung Cancer. 2020;139:S76-S