Healthcare delivery research in older adults with cancer: A review of National Institutes of Health-funded projects

Abstract

Background: Cancer is a disease of aging, and most people with cancer are older than 65. However, widespread uptake of evidence-based approaches that facilitate quality care delivery for older adults with cancer are lacking. This project aimed to review National Institutes of Health (NIH) grants funded in the last decade that focused on healthcare delivery in aging and older adults with cancer, and to examine grant-related characteristics, study designs, and scientific topics included. Methods: A search was conducted of all extramural NIH research grants awarded between fiscal year 2012 to 2021. We examined NIH terms; keyword searches of titles, abstracts, and specific aims were implemented to maximize search efficiency. Extraction criteria focused on grant-related and study characteristics. A priori scientific topics for coding included geriatric assessment, care decision-making, communication, care coordination, physical and psychosocial functioning/symptoms, and clinical outcomes. Results: A total of 48 funded grants met the inclusion criteria. A near-equal split was observed between R03, R21, and R01 grants. Most grants did not include family caregivers or focus on end-of-life care. Most grants included multiple cancers and were conducted during active treatment and in hospital/clinic settings. Common scientific topics included geriatric assessment, care decision-making, physical and psychosocial functioning/symptoms, communication, and care coordination. Few grants focused on cognitive functioning. Conclusions: Several gaps in the portfolio were identified, including family caregiver inclusion, end-of-life care, and studies focusing on cognitive functioning.