Early specialized palliative care in Japan: a feasibility study

Abstract

Palliative care, defined by the World Health Organization, is “an approach that improves the quality of life of patients and their families facing the problem associated with life‐threatening illness.” In a randomized control trial, Temel, et al. (2010) showed that early specialized palliative care (ESPC) resulted in a variety of positive outcomes for advanced lung cancer patients, such as better quality of life, reduced depression, and prolonged life. Providing ESPC is important and recommendable for all advanced cancer patients; however, methods of provision are unclear due to difficulties of feasibility and reproducibility in different cultures and health care systems, limited human resources, and cost‐effectiveness. In addition, the mechanism of ESPC has not yet been sufficiently clarified. We therefore conducted a study on ESPC in Japan, with a nurse‐led screening‐triggered ESPC intervention for 50 patients with metastatic lung cancer who were undergoing first‐line chemotherapy. The feasibility study of this intervention was conducted in a single arm from August 2012 to March 2014 at the National Cancer Center Hospital East. Results showed that this intervention was feasible and potentially useful for improving quality of life and reducing depression and anxiety. On this basis, we will conduct a randomized controlled study of the nurse‐led screening‐triggered ESPC intervention in Japan. We also recommend that future research should study methods of effective ESPC delivery in different situations globally.