Preferences about information and decision-making among older patients with and without cancer

information of older patients with cancer is crucial to ensure optimal care.

to compare older patients with and without cancer regarding their preferences about medical information, decision-making and surrogate designation.

an intention-to-act questionnaire was completed by patients ≥70 y enroled in the ELderly CAncer PAtients cohort between January and June 2013 and by patients in the same age group enroled in a cross-sectional survey conducted in 2005 in acute geriatric wards.

Henri-Mondor Teaching Hospital in the Paris conurbation, France.

the group with cancer had 133 patients [mean age, 79.6 ± 6.5 y; 54.9% women]. The main tumour sites were colorectal [24.1%], breast [23.3%] and prostate [15.8%]; 34.8% had metastases. All these patients wanted full information, 74.2% wanted to participate in decisions about their care, 87.2% would designate a family member to serve as a surrogate in life-threatening situations and 15% had already designated a surrogate. Compared to patients without cancer, those with cancer more often wanted to receive information in a life-threatening situation [93.6% versus 79.2%; P< 0.001]. Factors independently associated with patients wanting their informed consent to be obtained for all interventions were having children [adjusted odds ratio (aOR), 2.13; 95% confidence interval, 1.24; 3.66; P = 0.006], higher Mini Mental State Examination score [aORper point, 1.09; 1.02; 1.17], younger age in the group without cancer [aOR>82 y vs. ≤82 y, 0.50; 0.29-0.88] and being cancer-free [≤82 y, aOR, 0.30; 0.14-0.63; >82 y, aOR, 0.41; 0.17-0.97].

older patients with cancer expressed a strong preference for receiving information and participating in decisions about their care.

Age and ageing. 2017 Jan 18 [Epub ahead of print]

Elena Paillaud, Florence Canoui-Poitrine, Gwenaelle Varnier, Narges Anfasi-Ebadi, Ester Guery, Olivier Saint-Jean, Mathilde Gisselbrecht, Thomas Aparicio, Sylvie Bastuji-Garin, Marie Laurent, Philippe Caillet

Department of Internal and Geriatric Medicine, Assistance Publique - Hopitaux de Paris, Henri-Mondor Hospital, Paris, Île-de-France, France ., CEpiA (Clinical Epidemiology and Ageing), University Paris-Est Créteil (UPEC) , EA 7376- IMRB, Creteil, France., Department of Internal and Geriatric Medicine, Assistance Publique - Hopitaux de Paris, Henri-Mondor Hospital, Paris, Île-de-France, France., Geriatrics Department, Assistance Publique - Hopitaux de Paris, Hôpital Européen Georges Pompidou, Paris, Île-de-France, France., Gastroenterology and Digestive Oncology Department, Assistance Publique - Hopitaux de Paris, Avicenne hospital, Bobigny, Île-de-France, France.


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