Boosting resilience with an electronic frailty index guided care plan

Resilience Enhancement Utilizing an Electronic Frailty Index-Directed Care Pathway for Older Adults Receiving Chemotherapy (RESILIENCE-e): A Prospective Single-Arm Interventional Study

This program sees if using an electronic frailty index to guide tailored supportive care and weekly symptom check-ins helps people 65 and older stay resilient while receiving chemotherapy.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 32 (estimated)
• Ages: 65 Years and up
• Sex: All
• Sponsor: Wake Forest University Health Sciences (other)
• Drugs / interventions: chemotherapy
• Locations: 2 sites (Charlotte, North Carolina and 1 other locations)
• Trial ID: NCT07175376 on ClinicalTrials.gov

What this trial studies

This is a prospective single-arm intervention enrolling adults aged 65 and older with active cancer who are pre-frail or frail by an EHR-based electronic frailty index (eFI) and are planning to start outpatient chemotherapy. After a baseline assessment participants receive their eFI results, are offered referrals to supportive care services, and complete weekly symptom reporting via electronic surveys plus a research nurse phone call for 12 weeks. Follow-up assessments occur at 12 weeks, and a subset of patients and treating providers will be invited for interviews to collect feedback on barriers and facilitators. The study is conducted at participating Atrium Health sites in North Carolina.

Who should consider this trial

Good fit: Ideal candidates are English-speaking adults aged 65 or older with an active cancer diagnosis who are pre-frail or frail by the eFI and are planning to start outpatient chemotherapy within the participating Atrium Health sites.

Not a fit: Patients already receiving chemotherapy, those who are not pre-frail or frail by the eFI, those with comorbidities that prevent participation, or those receiving chemotherapy outside the Atrium Health system are unlikely to benefit from or be eligible for this program.

Why it matters

Potential benefit: If successful, this approach could help older adults on chemotherapy stay more physically and mentally resilient, reduce symptom burden, and direct supportive services to those who need them most.

How similar studies have performed: Prior geriatric assessment–based interventions in oncology have shown improved outcomes like reduced toxicity and better care planning, but applying an EHR-derived eFI to drive a targeted supportive care pathway is relatively new and less well established.

Eligibility criteria

Inclusion Criteria:

Patients with cancer:

* Ability to understand and willingness to sign an IRB-approved informed consent
* Age ≥ 65 years at the time of enrollment.
* Planned to initiate an outpatient chemotherapy regimen for cancer treatment (any type or stage), either as an initial therapy or as a new line of therapy, with curative or palliative intent.
* eFI pre-frail or frail status (available in EHR) within 30 days before enrollment.
* Ability to read and understand the English language

Providers:

* Treating medical oncologist of at least one patient participant who enrolled on to the study and completed baseline assessment.

Exclusion Criteria:

Patients:

* Documented physical or psychological comorbidity that would limit participant's ability to understand or comply with study procedures for the entire length of the study per the enrolling investigator.
* Chemotherapy planned at a facility outside the Atrium Health system.
* Currently receiving chemotherapy

Where this trial is running

Charlotte, North Carolina and 1 other locations

• Levine Cancer Institute — Charlotte, North Carolina, United States (RECRUITING)
• Atrium Health Wake Forest Baptist Comprehensive Cancer Center — Winston-Salem, North Carolina, United States (RECRUITING)

Study contacts

• Principal investigator: Heidi Klepin, MD — Wake Forest University Health Sciences
• Study coordinator: James Morgan

Conditions: Cancer, Frail, Chemotherapy, Frailty Index, eFI score