A global scoping review of barriers and strategies to implementation of geriatric assessment in older adults with cancer.

Abstract

e13851 Background: There is a lack of practical application of evidence synthesized from the systematic exploration and summarization of barriers and strategies for implementing Geriatric Assessment (GA) in older adults with cancer on a global scale. This systematic scoping review aimed to map out and synthesize the evidence on barriers and strategies for GA implementation in older adults with cancer. Methods: A comprehensive, systematic search ofseven electronic databases (MEDLINE, PsycINFO, CINAHL, Web of Science, Proquest, Scopus, and Ageline) was conducted to identify peer-reviewed articles, from 1 st January 2013 to 30 th October 2024. Two researchers independently screened 2,871 records, extracted relevant data from 34 full-text study reports and conducted content analyses to synthesize the findings. Results: The 34 articles were classified into the following categories: cross-sectional surveys (n = 16), observational cohort studies (n = 7), randomized controlled trials (n = 3), single-arm intervention trials (n = 4), qualitative studies (n = 2) and mixed method (online surveys and interviews) (n = 2). The included articles were from 12 countries (United States (n = 7), The Netherlands (n = 5), Canada (n = 3), Japan (n = 4), France (n = 2), Australia (n = 3), United Kingdom (n = 2), Belgium (n = 1), Brazil (n = 1), India (n = 1), Mexico (n = 1), Portugal (n = 1)), with one global collaboration. Most study reports (29/34) were published in the past five years. Five overarching themes encompassing 27 barriers to implementing GA in older adults with cancer were identified and summarized. Additionally, 17 implementation strategies were extracted and synthesized through content analysis of the included articles. These findings informed the development of the initial draft of the Barriers and Strategies Checklist Template for Geriatric Assessment (BeST-GA), providing a comprehensive, consolidated summary of the scoping review's results. Conclusions: The literature confirms that barriers affecting GA implementation in older adults with cancer and the strategies to overcome them are unique to individual settings and require a tailored approach. The draft BeST-GA checklist should be further tested and may be used as a first step to assess the setting during the planning phase of GA implementation.