Physician-patient communication may help prevent falls among older adults with cancer
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Key takeaways:
- Older adults undergoing cancer treatment had a lower risk for falling if they discussed physical activity with their health care provider.
- People with lung, colorectal or prostate cancers derived particular benefit.
Older adults undergoing cancer treatment exhibited reduced risk for falling if they had discussions about physical activity with their health care provider, according to study results.
However, these conversations occurred less than 60% of the time, findings presented at ASCO Quality Care Symposium showed.
“[Although] falls can happen to anyone at any time, the risk is higher [among] people with cancer — particularly during the all-consuming period of cancer treatment,” Chuan Lu, MD, MPH, research assistant at Dana-Farber Cancer Institute, said in an ASCO press release. “This is especially worrisome for older patients, who often have poorer outcomes following a fall.
“There is increasing awareness among clinicians of the importance of discussing methods to reduce the risk and avoid consequential outcomes from falls, specifically by promoting physical activity to their older patients,” Lu added. “However, there is limited understanding of how well this information is communicated to older patients.”
Background and methods
Individuals undergoing cancer treatment can experience a variety of adverse events, including muscle weakness, nausea, loss of appetite, cognitive problems and fatigue.
Any of these conditions could increase risk for falling, and older adults — those aged at least 65 years — could sustain serious injury, according to study background.
“This study was designed to help reveal the realities of physician-patient interactions about physical activity to prevent falls in real-world clinical settings,” Lu said.
Researchers sampled 100,086 Medicare beneficiaries undergoing active cancer treatments from the Medicare Health Outcome Survey between 2018 and 2022.
Consultation with clinicians regarding physical activity served as the primary endpoint.
Results and next steps
About 30% of people in the cohort (median = 30.54%; range, 30.17-31.26) sustained a fall.
In cases when patients and health care providers discussed physical activity, these conversations more often began by patient initiation
During the course of the study period, more than half of patients in the cohort reported starting conversations about physical activity (median, 56.81%; range, 53.04-56.98). Just over half reported receiving advice from their health care provider to increase physical activity as a way to reduce their risk for falling (median 51.35%; range, 48.06-52.26).
Those rates did not change significantly over the study period.
Older adults who started conversations about physical activity with their clinician exhibited a significantly reduced risk for falls (OR = 0.78; 95% CI, 0.71-0.86), as did those who got advice from their provider (OR = 0.78; 95% CI, 0.71-0.86).
Discussions about physical activity appeared associated with significant reductions in risk for falls among people with certain cancer types, including lung cancer (OR = 0.66; 95% CI, 0.45-0.94), colorectal cancer (OR = 0.64; 95% CI, 0.43-0.94) and prostate cancer (OR = 0.66; 95% CI, 0.54-0.8).
Tumor location and treatment types could explain these reductions, Lu and colleagues concluded.
They plan to conduct more research on other factors that could contribute to falls among this population.
“[Although] we do not know how much or what type of activity the patients were doing, this study highlights that counseling about physical activity may reduce fall risk,” Eleonora Teplinsky, MD, head of breast and gynecologic medical oncology at Valley Health System and clinical assistant professor of medicine at Icahn School of Medicine at Mount Sinai, said in the press release. “Physical activity has many other benefits, as well, and should be considered as part of routine oncologic care.”
References:
- ASTRO. Conversation between doctors and older patients about physical activity may reduce falls during cancer treatment (press release). Available at: https://society.asco.org/about-asco/press-center/news-releases/conversations-between-doctors-and-older-patients-about. Published Sept. 23, 2024. Accessed Sept. 26, 2024.
- Lu C, et al. Abstract 224. Presented at: ASCO Quality Care Symposium; Sept. 27-28, 2024; San Francisco.
Collapse
Lu C, et al. Abstract 224. Presented at: ASCO Quality Care Symposium; Sept. 27-28, 2024; San Francisco.
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