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Table 2 Proposed geriatric interventions defined in protocol according to the eleven areas and screening tools used

From: Role of geriatric intervention in the treatment of older patients with cancer: rationale and design of a phase III multicenter trial

Area Indication Intervention
Modification of therapy Polypharmacy • Re-evaluate treatment indications (with general practitioner), optimize treatment according to elderly patient protocols.
• Use the STOPP-START* tool as a reference [37, 38].
Balancing chronic diseases CIRS-G* Grade ≥ 3, • Adaptation of therapy.
arterial hypertension, diabetes, arthritis, or sensory problems • Other non-drug interventions such as dietary advice, devices.
• Referral to specialist doctor.
Pain treatment Pain >1 on numeric scale • Drug: WHO levels 1–3 antalgic treatment
• Non-drug: physiotherapy, devices
Nutritional intervention Malnutrition (MNA* ≤ 17) • Referral to dietician (nutritional supplements, artificial nutrition, etc.)
Weight loss ≥5 % over 3 m, or ≥10 % over 6 m
At risk of malnutrition - 17 < MNA ≤ 23.5 • Advice on increasing dietary uptake (use of food pyramid adapted for elderly patients)
Physical activity Sedentary or at risk of falls • Recommend daily walk, walking upstairs, carrying groceries
Physiotherapy Difficulty with walking and balance (TUG*, and SPPB*). Fall in the last 12 m, weight loss, muscle loss • Prescribe physiotherapy for muscular reinforcement Work on balance, and getting up from lying down position
• Prescribe walking aids
Psychological support GDS* ≥ 6 • Consultation with psychologist or psychiatrist
Apparent anxiety (clinical assessment)
Antecedent of depression
Prevention of further cognitive impairment MMSE* < 24 • Behavioral monitoring during chemotherapy
• Prevention of confusion [39]
Treatment for sleeping disorders Positive screening score on adapted Epworth scale [40] • Introduction, modification or discontinuation of treatment by hypnosis according to STOPP and START recommendations [37, 38]
Assistance Social fragility identified (absence of social support) • Ask patient directly if help is needed
• Refer to a social worker
Home help Difficulties performing daily tasks such as grooming, housework • Prescribe support within the home (nursing, physiotherapy, housecleaner, etc.)
  1. *STOPP-START Screening Tool of Older persons’ prescriptions, CIRS-G Cumulative Illness Rating Scale for Geriatrics, MNA Mini Nutritional Assessment, TUG Timed Up and Go, SPPB Short Performance Physical battery, GDS Geriatric Depression Scale, MMSE Mini mental state examination