Proposed brief and simplified approach to screening patients with myeloma for frailty
| Measures . | Options . | Comments . |
|---|---|---|
| Performance status* | • ECOG • KPS | Consider patient-reported PS—can highlight subjective differences and prompt further evaluation95 |
| Documentation of comorbidities* | • CCI • HCT-CI • CIRS | Consider a validated index to quantify—can be useful to compare with published data and CCI incorporated into IMWG scoring system |
| Medication history* | Approaches to tackle polypharmacy broken down by health care setting in older adults with cancer (review)96 | Rather than simple documentation, greater emphasis on minimizing potential drug-drug interactions, dose reductions, and removing any unnecessary medications |
| Nutritional evaluation* | • Weight • HbA1C | Consider intervention for patients with significant weight loss >10% and those with comorbid or emergent diabetes |
| Geriatric screening tool | • G8 • Vulnerable Elders Survey 13 • Senior Adult Oncology Program | If abnormal—consider comprehensive geriatric screening or referral action based on low scoring domain19,22 |
| Cognitive screening | • Mini-Cog™ • Mini-mental state exam | |
| Physical functioning | • TUG | No specific training is needed to perform this test. Example available here: https://www.youtube.com/watch?v=tNay64Mab78 |
| Measures . | Options . | Comments . |
|---|---|---|
| Performance status* | • ECOG • KPS | Consider patient-reported PS—can highlight subjective differences and prompt further evaluation95 |
| Documentation of comorbidities* | • CCI • HCT-CI • CIRS | Consider a validated index to quantify—can be useful to compare with published data and CCI incorporated into IMWG scoring system |
| Medication history* | Approaches to tackle polypharmacy broken down by health care setting in older adults with cancer (review)96 | Rather than simple documentation, greater emphasis on minimizing potential drug-drug interactions, dose reductions, and removing any unnecessary medications |
| Nutritional evaluation* | • Weight • HbA1C | Consider intervention for patients with significant weight loss >10% and those with comorbid or emergent diabetes |
| Geriatric screening tool | • G8 • Vulnerable Elders Survey 13 • Senior Adult Oncology Program | If abnormal—consider comprehensive geriatric screening or referral action based on low scoring domain19,22 |
| Cognitive screening | • Mini-Cog™ • Mini-mental state exam | |
| Physical functioning | • TUG | No specific training is needed to perform this test. Example available here: https://www.youtube.com/watch?v=tNay64Mab78 |
Considered standard care. Adapted from Loh et al.23
CIRS, cumulative comorbidity rating score; HbA1c, hemoglobin A1c.