ABSTRACT
Objective: This study aimed to clarify the details of inpatient cancer rehabilitation interventions provided by designated cancer hospitals in Japan. Methods: This questionnaire-based survey asked specialists regarding the outline of their facilities’ inpatient cancer rehabilitation, Dietz classification, disease, and intervention details. Results: Restorative interventions were the most common, and the most common cancer was lung cancer followed by colorectal cancer; hematologic malignancy; gastric cancer; and liver, gallbladder, and pancreatic cancer. Intervention proportions for colorectal and gastric cancer were significantly higher in general hospitals than in university hospitals and cancer centers; in contrast, those for hematological malignancy were significantly higher in university hospitals than in general hospitals. For bone and soft tissue sarcomas, intervention proportions in cancer centers were significantly higher than those in university and general hospitals; and for oral, pharyngeal, and laryngeal cancers, they were significantly higher in university hospitals and cancer centers than in general hospitals. The most common intervention was walking training, followed by resistance training, basic motor training, activities of daily living training, and respiratory rehabilitation. Respiratory rehabilitation was performed significantly more frequently in university and general hospitals than in cancer centers.Conclusion: The diseases had differed according to the characteristics of the facilities, and the interventions were considered accordingly. In future, it will be necessary to verify the effectiveness of inpatient cancer rehabilitation according to facility characteristics and to disseminate information on inpatient cancer rehabilitation.
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Objective: This study aimed to investigate the feasibility of a patient registry system for assessing PCT (palliative care team) by PRO (Patient-reported outcome) in Japan. Methods: We operated a patient registry system with electronic data collection at eight hospitals in 2021 in Japan. We consecutively included newly referred patients for a month and followed up with them for a month. IPOS or ESAS obtained as PRO at the start of the intervention, three days later, and every week after. The primary endpoint was the response rate to the symptom rating scale by patients and providers. Results: 318 patients were enrolled. The patient response rate was 59.1% at intervention and 37.0% after intervention, and the medical provider response rate was 98.4% at intervention and 70.3% after intervention. Interviews with PCT members indicated that participants required support to input PRO responses required support and paper questionnaire was better and that managing the survey date and overall management was burdensome. Discussion: Although only about half of the patients were able to respond to the PRO, this was the same level as in previous studies. The system and its operation method have many problems. We found that improvements such as reducing items and making the patient interviews paper-based are necessary to expand the system nationwide.
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Introduction: Double dose of Goreisan was effective in a case of blepharophimosis due to facial edema caused by malignancy-related superior vena cava syndrome. Case: A 60-year old male patient diagnosed with squamous cell carcinoma of the tongue underwent brachytherapy, surgery, and several types of chemotherapy before cervical lymph node metastases developed. Cyberknife therapy was performed to reduce the volume of lymph node metastases, only to develop abscess and cause malignancy-related superior vena cava syndrome, leading to facial edema accompanied by blepharophimosis. Intravenous furosemide was not effective, so double dose of Goreisan, a traditional Chinese prescription was applied and the edema and blepharophimosis subsided immediately, thus enhanced the patient’s quality of life. Conclusion: Goreisan can be an effective option for cases of malignancy-related superior vena cava syndrome refractory to chemotherapy and/or radiotherapy.
ABSTRACT
Background: Previous surveys have demonstrated that a significant proportion of inpatients did not receive adequate pain management at an acute care hospital in Japan. Aim: The aim of this study was to evaluate the usefulness of a hospital-wide audit for assessing pain management with opioids according to the electronic medical records (EMRs) Methods: The subjects of this audit were inpatients receiving strong opioids who had not been consulted by the pallia. tive care team (PCT). The PCT held a weekly pharmacist-led conference to evaluate the adequacy and appropriateness of analgesics, including opioids, as well as drugs administered for adverse effects according to information collected by the PCT pharmacists. The PCT subsequently recorded the advisory comments in the EMRs. Each week, the PCT monitored whether the suggestions had been accepted by primary physicians and whether the pain and/or adverse effects had improved. Results: Among a total of 4,978 cases evaluated during the 3-year survey period, 888 (17.8％) had inadequate pain and/or adverse effect management. Symptoms improved in 82.3％ of cases for which PCT proposals were accepted. Conclusion: The results suggest that this hospital-wide audit may be useful for improving pain management with opioids at an acute care hospital.