Comprehensive geriatric assessment in oncology in Morocco: status report using an interpretive approach and recommendations

Abstract

In the context of Morocco’s progressively aging population, Comprehensive Geriatric Assessment (CGA) plays a major role in the early detection of frailty among older patients with cancer and in adapting care to their specific needs. The objectives of this study were to assess the current knowledge, perceptions and practices of Moroccan medical specialists (oncologists, hematologists, and geriatricians) regarding the use of CGA in the oncological care of older patients, to explore the gaps between its recognized value and its actual clinical integration, and to identify the barriers and facilitators to its implementation in order to propose an operational model adapted to Morocco’s specific health, sociocultural, and economic context. A multicenter exploratory qualitative study was conducted among 15 medical specialists in oncology, hematology, and geriatrics through in-depth, semi-structured individual interviews. Data from the interview notes were managed and analyzed using an interpretive description approach. Deductive thematic analysis revealed the complexity of managing older cancer patients, influenced by impaired general health status, comorbidities, and malnutrition. CGA is rarely implemented, although most physicians consider it essential. Many reported limited familiarity with specific CGA tools due to insufficient training. Assessment of the seven key domains is perceived as necessary but remains difficult to apply in practice. Implementation requires a specialized multidisciplinary team to ensure appropriate patient-centered care. The study highlights the importance of promoting CGA in oncology in Morocco, while considering existing organizational and structural constraints. Developing specialized training, ensuring the availability of a standardized tool, and improving access to geriatric services are essential to achieve more appropriate care for older patients.