Outpatient Department for Early Palliative Care: Retrospective Study

<p>We established the Early Palliative Care (EPC) outpatient department for patients who had received chemotherapy at other hospitals in August 2015. We retrospectively investigated medical records of patients who consulted the EPC outpatient department and patients who consulted the Medical Oncology outpatient department of our hospital between August 2015 and January 2016. The length of the first medical examination, the contents of the medical examination, period to hospitalization and period to death were investigated. Nineteen EPC outpatients and 11 Medical Oncology outpatients consulted a total of 80 times and 117 times at the respective outpatient department. The median length of the first medical examination in the EPC and Medical Oncology outpatient departments was 45 minutes (range, 10-106 minutes) and 38 minutes (range, 23-60 minutes), respectively (p=0.17). The contents of the examination in the EPC outpatient group included discussion about symptom management, coping, etc. Five patients (26%) in the EPC outpatient group passed away less than 60 days from the first medical examination. It would be possible for palliative physicians to establish and manage an EPC outpatient department in Japanese hospitals. However, some patients had late referral to the EPC outpatient department. Public awareness about EPC and the practice of EPC are important.</p>

Disclosure of Survival Prediction Prior to Referral to the Palliative Care Department: Retrospective Study

<p>There are few reports on the disclosure of survival prediction to patients themselves in Japan, and how concretely it is performed. We retrospectively studied the disclosure of survival prediction to patients who were referred for the first medical examination to the Palliative Care Department between April 2013 and March 2016. Two hundred forty-eight patients (and their families) met the study criteria. Forty-three percent of the patients and their families had received information on definite periods of life expectancy without probability or ranges. On the other hand, 19% of the patients and families had not been told about survival prediction by the previous physician. Our results suggest that patients and families often received information on definite periods of life expectancy. There will be a need for improvement of end-of-life discussion in Japan.</p>