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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

1179 - Perspectives and attitudes towards the integration of oncology and palliative care in Japan: A nationwide survey.

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

End-of-life Care

Tumour Site

Presenters

Uneno Yu

Citation

Annals of Oncology (2018) 29 (suppl_8): viii548-viii556. 10.1093/annonc/mdy295

Authors

U. Yu1, K. Sato2, T. Morita3, M. Mori4, C. Shimizu5, Y. Horie6, M. Hirakawa6, T.E. Nakajima6, S. Tsuneto7, M. Muto1

Author affiliations

  • 1 Department Of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 606-8507 - Kyoto city/JP
  • 2 Department Of Nursing, Nagoya University Graduate School of Medicine, 466-8560 - Nagoya city/JP
  • 3 Division Of Supportive And Palliative Care, Seirei Mikatahara General Hospital, 433-8558 - Hamamatsu city/JP
  • 4 Palliative Care Team, Seirei Mikatahara General Hospital, 433-8558 - Hamamatsu city/JP
  • 5 Breast Center, Center Hospital of the National Center for Global Health and Medicine, 162-8655 - Tokyo/JP
  • 6 Department Of Clinical Oncology, St Marianna University School of Medicine, 216-8511 - Kawasaki city/JP
  • 7 Department Of Human Health Sciences, Graduate School of Medicine, Kyoto University, 606-8507 - Kyoto city/JP
More

Resources

Abstract 1179

Background

Integration of oncology and palliative care (IOP) is recommended by several agencies, including the European Society for Medical Oncology. Given the slow evolution of IOP in practice, several barriers to its implementation may exist. Lack of institutional support is known to be one of the key barriers to IOP. However, institutional recognition towards IOP is less investigated. This was a cross-sectional nationwide survey to clarify the institutional perspectives and attitudes towards IOP in Japan.

Methods

We distributed a questionnaire to executives or directors of oncology departments at cancer hospitals on November 2017 and sent a reminder mail later. Since considerable number of patients are receiving cancer treatment at non-designated cancer hospitals (non-DCHs) in Japan, we performed comparison between designated cancer hospitals (DCHs) and non-DCHs. Questionnaire items were developed based on a comprehensive literature review. We conducted descriptive statistics, t-tests and Cochrane-Armitage trend tests where appropriate. To adjust the difference of inpatient beds scale, estimates of non-DCHs were weighted by the distribution of inpatient beds at DCHs.

Results

In total, 399 DCHs and 478 non-DCHs were surveyed, of which 269 (67%) and 259 (54%) responded, respectively. Most cancer hospitals considered their quality of palliative care (PC) services unsatisfying (75% vs. 76% (p = 0.674)), believed that IOP would be beneficial for their patients (85% vs. 89% (p = 0.933)) and did not regard it as costly (13% vs. 18% (p = 0.217)). DCHs had difficulty in recruiting PC physicians and non-DCHs in recruiting not only PC physicians but PC nurses and mental healthcare professionals. Although both were willing to facilitate an early referral to PC services (55% vs. 60% (p = 0.001)), less than 30% of hospitals was planning to increase full-time PC medical staff, inpatient PC beds and funding.

Conclusions

IOP was broadly recognised as beneficial for cancer patients and most institutions were willing to facilitate IOP. However, few institutions were planning to address their limited clinical resources. Strategies, such as the rearrangement of reimbursement systems or education for healthcare professionals, need to be investigated.

Clinical trial identification

Legal entity responsible for the study

Graduate School of Medicine, Kyoto University.

Funding

This research is funded by the Ministry of Health Labor and Welfare in Japan (Health Labor Science Research Grant).

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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