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  1. Article ; Online: Performance of potentially inappropriate medications assessment tools in older Indian patients with cancer.

    Kumar, Sharath / Castelino, Renita / Rao, Abhijith / Gattani, Shreya / Kumar, Anita / Pillai, Anupa / Sehgal, Arshiya / Rane, Pallavi / Ramaswamy, Anant / Dhekale, Ratan / Krishnamurthy, Jyoti / Banavali, Shripad / Badwe, Rajendra / Prabhash, Kumar / Noronha, Vanita / Gota, Vikram

    Cancer medicine

    2024  

    Abstract: Background: Polypharmacy and potentially inappropriate medication (PIM) use are common problems in older adults. Safe prescription practices are a necessity. The tools employed for the identification of PIM sometimes do not concur with each other.: ... ...

    Abstract Background: Polypharmacy and potentially inappropriate medication (PIM) use are common problems in older adults. Safe prescription practices are a necessity. The tools employed for the identification of PIM sometimes do not concur with each other.
    Methods: A retrospective analysis of patients ≥60 years who visited the Geriatric Oncology Clinic of the Tata Memorial Hospital, Mumbai, India from 2018 to 2021 was performed. Beer's-2015, STOPP/START criteria v2, PRISCUS-2010, Fit fOR The Aged (FORTA)-2018, and the EU(7)-PIM list-2015 were the tools used to assess PIM. Every patient was assigned a standardized PIM value (SPV) for each scale, which represented the ratio of the number of PIMs identified by a given scale to the total number of medications taken. The median SPV of all five tools was considered the reference standard for each patient. Bland-Altman plots were utilized to determine agreement between each scale and the reference. Association between baseline variables and PIM use was determined using multiple logistic regression analysis.
    Results: Of the 467 patients included in this analysis, there were 372 (79.66%) males and 95 (20.34%) females with an average age of 70 ± 5.91 years. The EU(7)-PIM list was found to have the highest level of agreement given by a bias estimate of 0.010, the lowest compared to any other scale. The 95% CI of the bias was in the narrow range of -0.001 to 0.022, demonstrating the precision of the estimate. In comparison, the bias (95%) CI of Beer's criteria, STOPP/START criteria, PRISCUS list, and FORTA list were -0.039 (-0.053 to -0.025), 0.076 (0.060 to 0.092), 0.035 (0.021 to 0.049), and -0.148 (-0.165 to -0.130), respectively. Patients on polypharmacy had significantly higher PIM use compared to those without (OR = 1.47 (1.33-1.63), p = <0.001).
    Conclusions: The EU(7)-PIM list was found to have the least bias and hence can be considered the most reliable among all other tools studied.
    Language English
    Publishing date 2024-01-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2659751-2
    ISSN 2045-7634 ; 2045-7634
    ISSN (online) 2045-7634
    ISSN 2045-7634
    DOI 10.1002/cam4.6797
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: An analysis of psychological problems in older Indian patients with cancer.

    Kumar, Anita / Sonkusare, Lekhika / Noronha, Vanita / Deodhar, Jayita / Rao, Abhijith Rajaram / Kumar, Sharath / Castellino, Renita / Gattani, Shreya / Dhekale, Ratan / Krishnamurthy, Jyoti / Mahajan, Sarika / Daptadar, Anuradha / Ansari, Nabila / Vagal, Manusha / Gota, Vikram / Mahajan, Purabi / Nookala, Manjunath / Chitre, Ankita / Banavali, Shripad /
    Prabhash, Kumar / Badwe, Rajendra / Ramaswamy, Anant

    Journal of geriatric oncology

    2024  Volume 15, Issue 4, Page(s) 101744

    MeSH term(s) Humans ; Aged ; Neoplasms/psychology ; Neoplasms/epidemiology ; India/epidemiology ; Male ; Female ; Aged, 80 and over ; Middle Aged ; Mental Disorders/epidemiology ; Mental Disorders/psychology
    Language English
    Publishing date 2024-03-27
    Publishing country Netherlands
    Document type Letter ; Journal Article
    ZDB-ID 2556813-9
    ISSN 1879-4076 ; 1879-4068
    ISSN (online) 1879-4076
    ISSN 1879-4068
    DOI 10.1016/j.jgo.2024.101744
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Assessing frailty in older Indian patients before cancer treatment: Comparative analysis of three scales and their implications for overall survival.

    Rao, Abhijith R / Noronha, Vanita / Ramaswamy, Anant / Kumar, Anita / Pillai, Anupa / Gattani, Shreya / Sehgal, Arshiya / Kumar, Sharath / Castelino, Renita / Pearce, Jessica / Dhekale, Ratan / Jagtap, Pravin / Tripathi, Vinod / Satamkar, Sunita / Krishnamurthy, Jyoti / Mahajan, Sarika / Daptardar, Anuradha / Sonkusare, Lekhika / Deodhar, Jayita /
    Ansari, Nabila / Vagal, Manjusha / Mahajan, Purabi / Timmanpyati, Shivshankar / Nookala, Manjunath / Chitre, Ankita / Kapoor, Akhil / Gota, Vikram / Banavali, Shripad / Badwe, Rajendra A / Prabhash, Kumar

    Journal of geriatric oncology

    2024  Volume 15, Issue 3, Page(s) 101736

    Abstract: Introduction: Frailty, characterized by ageing-related vulnerability, influences outcomes in older adults. Our study aimed to investigate the relationship between frailty and clinical outcomes in older Indian patients with cancer.: Materials and ... ...

    Abstract Introduction: Frailty, characterized by ageing-related vulnerability, influences outcomes in older adults. Our study aimed to investigate the relationship between frailty and clinical outcomes in older Indian patients with cancer.
    Materials and methods: Our observational single-centre study, conducted at Tata Memorial Hospital from February 2020 to July 2022, enrolled participants aged 60 years and above with cancer. Frailty was assessed using the Clinical Frailty Scale (CFS), G8, and Vulnerable Elders Survey (VES)-13. The primary objective was to explore the correlation between baseline frailty and overall survival. Statistical analyses include Kaplan-Meier, Cox proportional hazards, and Harrell's C test.
    Results: A total of 1,177 patients (median age 68, 76.9% male) were evaluated in the geriatric oncology clinic. Common malignancies included lung (40.0%), gastrointestinal (35.8%), urological (11.9%), and head and neck (9.0%), with 56.5% having metastatic disease. Using CFS, G8, and VES-13 scales, 28.5%, 86.4%, and 38.0% were identified as frail, respectively. Median follow-up was 11.6 months, with 43.3% deaths. Patients fit on CFS (CFS 1-2) had a median survival of 28.02 months, pre-frail (CFS 3-4) 13.24 months, and frail (CFS ≥5) 7.79 months (p < 0.001). Abnormal G8 (≤14) and VES-13 (≥3) were associated with significantly lower median survival (p < 0.001). Multivariate analysis confirmed CFS's predictive power for mortality (p < 0.001), with hazard ratios [HRs] for pre-frail at 1.61(95% confidence interval [CI] 1.25 to 2.06) and frail at 2.31 (95%CI 1.74 to 3.05). G8 ≤ 14 had HR 2.00 (95%CI 1.42 to 2.83), and abnormal VES-13 had HR 1.36 (95%CI 1.11-1.67). In the likelihood ratio test, CFS significantly improved the model fit (p < 0.001). Harrell's C index for survival prediction was 0.62 for CFS, 0.54 for G8, and 0.58 for VES-13.
    Discussion: In conclusion, our study highlights varying frailty prevalence and prognostic implications in older Indian patients with cancer, emphasizing the need for personalized care in oncology for this aging population. We would recommend using CFS as a tool to screen for frailty for older Indian patients with cancer.
    MeSH term(s) Humans ; Male ; Aged ; Female ; Frailty/diagnosis ; Frailty/epidemiology ; Neoplasms/therapy ; Neoplasms/pathology ; Prognosis ; Proportional Hazards Models ; Surveys and Questionnaires
    Language English
    Publishing date 2024-02-29
    Publishing country Netherlands
    Document type Observational Study ; Journal Article
    ZDB-ID 2556813-9
    ISSN 1879-4076 ; 1879-4068
    ISSN (online) 1879-4076
    ISSN 1879-4068
    DOI 10.1016/j.jgo.2024.101736
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: The current status of geriatric oncology in India.

    Noronha, Vanita / Rao, Abhijith Rajaram / Ramaswamy, Anant / Kumar, Anita / Pillai, Anupa / Dhekale, Ratan / Krishnamurthy, Jyoti / Kapoor, Akhil / Gattani, Shreya / Sehgal, Arshiya / Kumar, Sharath / Castelino, Renita / Mahajan, Sarika / Daptardar, Anuradha / Sonkusare, Lekhika / Deodhar, Jayita / Ansari, Nabila / Vagal, Manjusha / Mahajan, Purabi /
    Timmanpyati, Shivshankar / Nookala, Manjunath / Chitre, Ankita / Narasimhan, Prem Naganath / Banerjee, Joyita / Gota, Vikram / Banavali, Shripad / Badwe, Rajendra A / Prabhash, Kumar

    Ecancermedicalscience

    2023  Volume 17, Page(s) 1595

    Abstract: Geriatric oncology in India is relatively new. The number of older persons with cancer is increasing exponentially; at our institution, 34% of patients registered are 60 years and over. Apart from the Tata Memorial Hospital in Mumbai, there are currently ...

    Abstract Geriatric oncology in India is relatively new. The number of older persons with cancer is increasing exponentially; at our institution, 34% of patients registered are 60 years and over. Apart from the Tata Memorial Hospital in Mumbai, there are currently no other Indian centers that have a dedicated geriatric oncology unit. Geriatric assessments (GAs) are done sporadically, and older patients with cancer are usually assessed and treated based on clinical judgement. Challenges to increasing the uptake of GA include a lack of training/time/interest or knowledge of the importance of the GA. Other challenges include a lack of trained personnel with expertise in geriatric oncology, and a paucity of research studies that seek to advance the outcomes in older Indian patients with cancer. We anticipate that over the next 10 years, along with the inevitable increase in the number of older persons with cancer in India, there will be a commensurate increase in the number of skilled personnel to care for them. Key goals for the future include increased research output, increased number of dedicated geriatric oncology units across the country, India-specific geriatric oncology guidelines, geriatric oncology training programs, and a focus on collaborative work across India and with global partners. In this narrative review, we provide a broad overview of the status of geriatric oncology in India, along with a description of the work done at our center. We hope to spark interest and provide inspiration to readers to consider developing geriatric oncology services in other settings.
    Language English
    Publishing date 2023-08-31
    Publishing country England
    Document type Journal Article ; Review
    ISSN 1754-6605
    ISSN 1754-6605
    DOI 10.3332/ecancer.2023.1595
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Validation of the Onco-MPI in predicting short-term mortality in older Indian patients with cancer.

    Shenoy, Ramnath / Rao, Abhijith Rajaram / Rane, Pallavi Pratisad / Noronha, Vanita / Kumar, Anita / Pillai, Anupa / Pathak, Shruti / Gattani, Shreya / Sehgal, Arshiya / Kumar, Sharath / Castelino, Renita / Dhekale, Ratan / Krishnamurthy, Jyoti / Mahajan, Sarika / Daptardar, Anuradha / Sonkusare, Lekhika / Deodhar, Jayita / Ansari, Nabila / Vagal, Manjusha /
    Mahajan, Purbi / Timmanpyati, Shivshankar / Nokala, Manjunath / Chitre, Ankita / Kapoor, Akhil / Gota, Vikram / Banavali, Shripad / Prabhash, Kumar / Ramaswamy, Anant

    Journal of geriatric oncology

    2023  Volume 14, Issue 6, Page(s) 101550

    Abstract: Introduction: The number of older patients with cancer is increasing exponentially worldwide, and a similar trend has also been noted in India. The Multidimensional Prognostic Index (MPI) strongly correlates the presence of individual comorbidities with ...

    Abstract Introduction: The number of older patients with cancer is increasing exponentially worldwide, and a similar trend has also been noted in India. The Multidimensional Prognostic Index (MPI) strongly correlates the presence of individual comorbidities with mortality, and the Onco-MPI prognosticates patients accurately for overall mortality. However, limited studies have evaluated this index in patient populations beyond Italy. We evaluated the performance of the Onco-MPI index in predicting mortality in older Indian patients with cancer.
    Materials and methods: This observational study was conducted between October 2019 and November 2021 in the Geriatric Oncology Clinic at Tata Memorial Hospital in Mumbai, India. The data of patients aged ≥60 years with solid tumors who underwent a comprehensive geriatric assessment was analysed. The study's primary aim was to calculate the Onco-MPI for patients in the study and correlate it with one-year mortality.
    Results: A total of 576 patients aged ≥60 years were included in the study. The median age (range) of the population was 68 (60-90) years, and 429 (74.5%) were male. After a median follow-up of 19.2 months, 366 (63.7%) patients had died. The proportion of patients classified as low risk (0-0.46), moderate risk (0.47-0.63) and high risk (0.64-1.0) were 38% (219 patients), 37% (211 patients) and 25% (145 patients), respectively. There was a significant difference in one-year mortality rates between the low-risk patients compared to medium and high-risk patients (40.6% vs 53.1% vs 71.7%; p < 0.001).
    Discussion: The current study validates the Onco-MPI as a predictive tool for estimating short-term mortality in older Indian patients with cancer. Further prospective studies need to build on this index to obtain a score with greater discrimination in the Indian population.
    MeSH term(s) Aged ; Humans ; Male ; Female ; Prospective Studies ; Prognosis ; Neoplasms ; Geriatric Assessment/methods ; Time Factors
    Language English
    Publishing date 2023-06-14
    Publishing country Netherlands
    Document type Observational Study ; Journal Article
    ZDB-ID 2556813-9
    ISSN 1879-4076 ; 1879-4068
    ISSN (online) 1879-4076
    ISSN 1879-4068
    DOI 10.1016/j.jgo.2023.101550
    Database MEDical Literature Analysis and Retrieval System OnLINE

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