Table 2 Current status of major indicators in the integration of oncology and palliative care programs in Japan
From: Current status of integrating oncology and palliative care in Japan: a nationwide survey
Designated Cancer Hospitals (n = 269) | Non-Designated Cancer Hospitals (n = 150) | P value | Adjusted P value | |
|---|---|---|---|---|
n (%) | n (%) | |||
Clinical structure | ||||
Presence of palliative care inpatient consultation team | < 0.001 | < 0.001 | ||
involving full-time both physicians and nurses | 142 (52.8) | 21 (14.0) | ||
involving full-time physicians only | 1 (0.4) | 5 (3.3) | ||
involving full-time nurses only | 103 (38.3) | 37 (24.7) | ||
involving part-time both physicians and nurses | 17 (6.3) | 68 (45.3) | ||
not available | 1 (0.4) | 17 (11.3) | ||
Presence of palliative care outpatient clinic | < 0.001 | < 0.001 | ||
available ≥5 days a week | 85 (31.6) | 16 (10.7) | ||
available 3–4 days a week | 43 (16.0) | 15 (10.0) | ||
available < 1–2 days a week | 128 (47.6) | 56 (37.3) | ||
not available | 7 (2.6) | 60 (40.0) | ||
Clinical process | ||||
Presence of interdisciplinary palliative care teama1 | 265 (98.5) | 135 (90.0) | < 0.001 | 0.015 |
Members of palliative care team | ||||
Pain clinicians or anesthesiologists | 117 (43.5) | 40 (26.7) | < 0.001 | 0.024 |
Palliative care physicians expecting pain clinicians or anesthesiologists | 225 (83.6) | 122 (81.3) | 0.61 | 0.208 |
Palliative care nurses | 265 (98.5) | 132 (88.0) | < 0.001 | < 0.001 |
Healthcare professionals treating psychological issues (e.g., psychotherapist, psychiatrist, chaplain, or social worker) | 247 (91.8) | 100 (66.7) | < 0.001 | < 0.001 |
Medical social workers | 215 (79.9) | 93 (62.0) | < 0.001 | 0.008 |
Nutritionists | 181 (67.2) | 88 (58.7) | 0.085 | 0.435 |
Pharmacists | 259 (96.3) | 133 (88.7) | 0.001 | 0.024 |
Others | 100 (37.2) | 40 (26.7) | 0.031 | 0.028 |
Routine symptom screening in the outpatient oncology clinic | < 0.001 | 0.003 | ||
All departments (100%) | 78 (29.0) | 21 (14.0) | ||
Most departments (75–99%) | 62 (23.0) | 21 (14.0) | ||
Approximately half departments (25–74%) | 35 (13.0) | 10 (6.7) | ||
Limited departments (1–24%) | 71 (26.4) | 41 (27.3) | ||
No department (0%) | 19 (7.1) | 53 (35.3) | ||
Routine documentation of advance care plans in patients with advanced cancer | 0.050 | 0.183 | ||
All departments (100%) | 40 (14.9) | 17 (11.3) | ||
Most departments (75–99%) | 42 (15.6) | 14 (9.3) | ||
Approximately half departments (25–74%) | 23 (8.6) | 12 (8.0) | ||
Limited departments (1–24%) | 47 (17.5) | 31 (20.7) | ||
No department (0%) | 111 (41.3) | 71 (47.3) | ||
Early referral to palliative care using time trigger (e.g., 3 months after the diagnosis of incurability) | 0.700 | 0.358 | ||
All departments (100%) | 12 (4.5) | 7 (4.7) | ||
Most departments (75–99%) | 13 (4.8) | 5 (3.3) | ||
Approximately half departments (25–74%) | 15 (5.6) | 8 (5.3) | ||
Limited departments (1–24%) | 26 (9.7) | 14 (9.3) | ||
No department (0%) | 199 (74.0) | 113 (75.3) | ||
Early referral to palliative care using needs trigger (e.g., pain with NRS ≥7) | 0.030 | 0.820 | ||
All departments (100%) | 49 (18.2) | 19 (12.7) | ||
Most departments (75–99%) | 35 (13.0) | 10 (6.7) | ||
Approximately half departments (25–74%) | 18 (6.7) | 12 (8.0) | ||
Limited departments (1–24%) | 20 (7.4) | 16 (10.7) | ||
No department (0%) | 143 (53.2) | 90 (60.0) | ||