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Implementing a Geriatric Assessment-Guided Rehabilitation Care Model in Community Oncology Care: Feasibility and Impact on Patient-Reported and Performance-Based Outcomes †
by
, , ,
Mackenzi Pergolotti
1,2,3,*
,
Kelley C. Wood
1,
Mary Hidde
1,4,
Tiffany D. Kendig
1,
Deanna Meehan
5,
Katie Hutzayluk
5,
Alaina M. Newell
1,6,
Jessica Bertram
7,
Ashley Lightner
1,
Stacye Mayo
1,
Alina Hedaya
1,5,
Smith Giri
8,9 and
Grant R. Williams
8,9 1
ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA 17055, USA
2
Department of Occupational Therapy, University of North Carolina, Chapel Hill, NC 27599, USA
3
Department of Occupational Therapy, Colorado State University, Fort Collins, CO 80523, USA
4
Medpace, Inc., Denver, CO 80202, USA
5
Kessler Rehabilitation Center, Kessler Institute for Rehabilitation, Select Medical, Chester, NJ 07930, USA
6
Department of Physical Therapy, South College, Knoxville, TN 37909, USA
7
Outpatient Division, Baylor Scott and White Institute for Rehabilitation, Dallas, TX 75246, USA
8
Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL 35233, USA
9
Lewis and Faye Manderson Cancer Center, Tuscaloosa, AL 35401, USA
*
Author to whom correspondence should be addressed.
†
This paper is an extension of a conference paper. Kendig, T.; Wood, K.C.; Bertram, J.; Hidde, M.; Ronnen, E.A.; Lightner, A.N.; Mayo, S.; Hedaya, A.; Newell, A.M.; Meehan, D.; Hutzayluk, K.; Carroll, R.; Williams, G.R.; Pergolotti, M. Using an electronic capture geriatric assessment to guide rehabilitation triage for adults with cancer during systemic therapy. J. Clin. Oncol. 2023, 19, 474–474. https://doi.org/10.1200/OP.2023.19.11_SUPPL.474
Cancers 2025, 17(19), 3274; https://doi.org/10.3390/cancers17193274
Submission received: 4 August 2025
/
Revised: 24 September 2025
/
Accepted: 1 October 2025
/
Published: 9 October 2025
(This article belongs to the Special Issue Treatment Outcomes in Older Adults with Cancer)
Simple Summary
This study assessed the feasibility of conducting an online monthly geriatric assessment (GA) to identify frailty in adults with cancer who were about to begin a new treatment at a community oncology practice. The GA classified patients into three categories: frail, pre-frail, or robust. Patients identified as frail or pre-frail were referred to outpatient cancer rehabilitation services, including physical and occupational therapy. Feedback from participants indicated that this approach was both feasible and well received. Furthermore, those who attended rehabilitation experienced significant improvements in quality of life, mobility, fitness, and strength.
Abstract
Background: Adults with cancer who are pre-frail or frail are at risk of poor outcomes. Geriatric assessment (GA) is recommended to assess and manage vulnerability and risk of frailty in older adults with cancer (≥65) and to inform referrals in supportive services, including rehabilitation. Yet, adoption of the GA in community oncology practice lags, and frailty among adults younger than 65 often goes undetected and/or unaddressed. We evaluated the feasibility of a GA-guided rehabilitation care model and assessed changes in patient-reported and performance-based outcomes after rehabilitation. Methods: Adults (≥18 years) starting systemic therapy at a community oncology practice enrolled in the study. The GA was administered online and monthly for one year. Frailty/pre-frailty was identified using a previously validated 44-item index. The oncology team was notified of frail/pre-frail patients and then made referrals to outpatient rehabilitation. Feasibility outcomes (recruitment, retention, fidelity) and participant acceptability [7 items, 0–5 Likert scale] were analyzed descriptively. Patient-reported and performance-based outcomes were examined using the paired t-test. Results: 48% of eligible patients enrolled (N = 141), and 83% completed at least one GA. Frailty/pre-frailty was identified in 40% of the GAs, resulting in 282 referrals to rehabilitation (99% fidelity). Acceptability scores ranged from 3.5 ± 1.7 to 4.7 ± 0.6. Participants who attended rehabilitation (52%) improved significantly in outcomes measuring health-related quality of life, mobility, aerobic capacity, and strength (all p < 0.05). Conclusion: Implementing a GA-guided rehabilitation care model was feasible and acceptable to patients receiving systemic treatment. Those who attended rehabilitation experienced significant improvement in patient-reported and performance-based outcomes.
