Myeloma Patients

Section 1 – Treatment and Management

1. How many patients has your Trust diagnosed with multiple myeloma in the calendar year 2014? 24

2. How many multiple myeloma patients in your Trust received systemic anti-cancer treatment in the calendar year 2014? 13

3. How many patients aged 75 years and over has your Trust diagnosed with multiple myeloma in the calendar year 2014? 13

4. How many multiple myeloma patients aged 75 years and over in your Trust received systemic anti-cancer treatment in the calendar year 2014? 5

5. Does your Trust produce local guidelines to support the management of elderly cancer patients? Supportive care guidelines reference management of elderly cancer where necessary.

6. Does your Trust produce local guidelines to support the management of elderly multiple myeloma patients? Guidelines, pathways and protocols make reference to management in the elderly where necessary.

(Note: Multiple Myeloma is defined by the ICD-10 code as C90.0 – C90.3)

Section 2 – Specialist Geriatric Input

7. Does your Trust’s multiple myeloma multidisciplinary team (MM MDT) include input from a geriatrician? No but support is provided by OPAL (older people’s advice and liaison) where needed.

a. If so, does a geriatrician routinely attend all MM MDT meetings? No
b. How often does the MM MDT meet? Weekly

8. Do multiple myeloma patients aged 75 and over at diagnosis routinely receive a consultation with a geriatrician? No, only if there are concerns.
a. If so, does this happen prior to making a decision as to whether a patient is suitable for systemic anticancer therapy? N/A
b. If, so does information from this consultation feed into clinical decision making? N/A

9. How frequently do all multiple myeloma patients aged 75 years and over receive a consultation with a geriatrician? As and if needed.
a. How is this information used in these consultations fed into clinical management and decision making? Clinical Liaison

Section 3 – Specific Tools and Metrics

10. Does your Trust use Comprehensive Geriatric Assessment to assess if a patient with cancer is suitable for treatment? No
a. If so, what proportion of multiple myeloma patients aged 75 and over received the assessment in 2014? N/A
b. Who routinely carries out this assessment (i.e. a nurse or a consultant – and what type of consultant (haematologist or geriatric))? N/A

11. Does your Trust routinely assess patients over the age of 75 according to a Comorbidity Score (either a standardised score such as the Charlson index or a local ‘in house’ score, please specify)? No
a. If so, what proportion of multiple myeloma patients aged 75 and over received the assessment in 2014? N/A
b. Who routinely carries out this assessment (i.e. a nurse or a consultant – and what type of consultant (haematologist or geriatric))? N/A

12. Does your Trust routinely assess patients over the age of 75 according to a Clinical Frailty Scale (either a standardised scale or a local ‘in house’ scale, please specify)? The Royal Surrey County Hospital NHS Foundation Trust uses a falls proforma in the Emergency Department for patients over 65 years. The Trust is also in the process of introducing a frailty tool in the emergency floor to identify frailty as part of the initial assessment to bring forward CGA (Comprehensive Geriatric Assessment).
a. If so, what proportion of multiple myeloma patients aged 75 and over received the assessment in 2014? Not in use in 2014
b. Who routinely carries out this assessment (i.e. a nurse or a consultant – and what type of consultant (haematologist or geriatric))? Geriatrician

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