HSR20-093: Psychosocial Support in Older Patients With Metastatic Breast Cancer (MBC) Treated at Community Centers

Authors: Bianca Lewis BA1, Caitlin R. Meeker MPH1, Elizabeth Handorf PhD1, Kelly Filchner MSN, RN, OCN, CCRC1, Rino Seedor MD1, Jennifer S. Winn MD, MS1, Lori J. Goldstein MD1, and Efrat Dotan MD1
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  • 1 Fox Chase Cancer Center, Philadelphia, PA

Background: Geriatric Assessment (GA) is the recommended tool for evaluating an older patient’s fitness for treatment. Research demonstrates a strong association between psychosocial status, a component of GA, and cancer outcomes. In an exploratory analysis, we sought to describe the psychosocial profile of older community patients with MBC, and investigate the correlation between psychosocial factors and presence of other GA abnormalities. Methods: This study included hands-on experience incorporating a patient- self geriatric assessment for patients ≥65-years-old with MBC. Psychosocial factors: depression and social support (SS), were captured in addition to other geriatric domains (functional status, comorbidity, cognition, and nutrition). SS was further delineated into two domains: objective social support (marital status and living situation), and perceived social support (responses on the 12-item Medical Outcomes Study Social Support Survey (MOS)). The 12-item MOS captures both tangible and emotional support. Depression was captured using the Geriatric Depression Scale (GDS). Descriptive statistics were used to evaluate the co-occurrence of psychosocial and geriatric abnormalities. Results: 100 older patients with MBC from 9 community practices underwent a GA; average age 73.9 (range 65-90). Majority of patients had some form of objective social support (OSS): 63% lived with at least one other person, and 53% were either married or in a domestic partnership. 31% lived alone; of these patients 65% indicated low perceived social support (PSS). Single and widowed patients had higher incidences of low PSS (69%, 80%), compared to only 37% of married patients. As PSS and GDS scores increased (indicating lower psychosocial status), a patient’s chances of having a higher number of GA abnormalities overall, increased. Most common geriatric abnormalities that co-occurred with low PSS included significant comorbidities (≥3 or more), borderline depression scores, cognitive dysfunction, and risk of fall occurring in 100%, 80%, 72%, and 76%, respectively. Emotional support (ES) was the most prominent PSS deficit across the cohort (71%). Conclusions: Psychosocial deficits are associated with higher incidence of geriatric abnormalities in older patients with MBC treated in the community. Social support deficits are common among older patients with MBC in the community, and need to be carefully evaluated and addressed in order to optimize treatment outcomes.

Corresponding Author: Bianca Lewis, BA
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