The Perceptions of Patients, Carers and Clinicians Relating to SACT Decision‐Making in Older People With Cancer: Qualitative Findings From the Electronic Frailty Index (eFI) in Cancer Study

Objective: To explore the perceptions and experiences of patients, carers and clinicians relating to treatment decision‐making in older people with cancer, and to investigate the acceptability of the eFI as a tool to influence decisions about SACT. Methods: Qualitative interviews were conducted with 28 participants (12 clinicians, 10 patients and 6 carers) at an NHS cancer day unit in South East England. Patients were > 60 years and had received at least one cycle of SACT. Data were analysed using framework analysis. Results: Two themes were identified. Theme one highlighted that the assessment of frailty is a variable and complex task. However, an individualised assessment incorporating a balance between quality of life and the potential benefit of treatment is fundamentally important. Theme two identified that eFI is an acceptable addition to SACT decision‐making which must be discussed with the patient and considered within the context of each individual situation. Conclusion: The eFI is acceptable for use in assessing the frailty of older people with cancer prior to starting SACT. In‐depth, individualised assessment prior to SACT is important in this population, but it is not always realistic. Incorporating the eFI into SACT decision‐making offers the potential to address this challenge.