Family-Integrated Advance Care Planning for Cancer Patients: A Mixed-Methods Feasibility Study.

Context: Advance care planning programs which focus on facilitating conversations among families are scant. We developed a family-integrated Serious Illness Conversation Guide (SICG-Fam).

Objectives: This study aims to examine the ability and acceptability of the SICG-Fam for advanced cancer patients, family members and physicians in Japan.

Palliative care consultation needs of certified primary care physicians in Japan: nationwide observational study.

Purpose: Japan has insufficient palliative care specialists, so there are calls for a palliative care consultation system to aid primary care physicians. Community-based palliative care may require clarification on the division of tasks and responsibilities. Primary care physicians' needs specific to palliative care are also ambiguous.

Pharmacological Strategies for Providing Patients With Delirium Relief From Terminal Dyspnea: A Secondary Data Analysis.

Introduction: Systemic opioids are recommended as a pharmacological treatment for dyspnea, and antipsychotics are widely used for delirium. Because little is known about optimal palliative pharmacological strategies for dyspnea in patients with delirium, this study explored the symptom course in such cases, including the use of opioids and antipsychotics.

Methods: This was a secondary analysis of a multicenter prospective and observational study.

Clinical Implications of the C-Reactive Protein-Albumin Ratio as a Prognostic Marker in Terminally Ill Patients with Cancer.

Few studies investigated the clinical implications of C-reactive protein-albumin ratio (CAR) in palliative care. To determine the association of CAR with overall survival among terminally ill patients with cance. Datasets were obtained through two multicenter prospective cohort studies.

Prediction of Next-Day Survival in Imminently Dying Cancer Patients: A Multicenter Cohort Study.

Accurate prediction of next-day survival in imminently dying patients is crucial for facilitating timely end-of-life decisions. To develop diagnostic models for predicting next-day survival in cancer patients with a Palliative Performance Scale (PPS) score of ≤20. A multicenter, prospective, observational study.

Optimal Machine Learning Models for Developing Prognostic Predictions in Patients With Advanced Cancer.

Context: Accurate prognosis prediction for cancer patients in palliative care is critical for clinical decision-making and personalized care. Traditional statistical models have been complemented by machine learning approaches; however, their comparative effectiveness remains underexplored.

Objectives: To assess the prognostic accuracy of statistical and machine learning models in predicting 30-day survival in patients with advanced cancer using objective data, such as the result of the blood test.

Hospital function-associated deaths among patients with cancer: a comprehensive national study using death records in Japan.

Background: In Japan, about 70%-80% of cancer deaths occur in hospitals. The actual number of cancer patients who die in hospitals where palliative care is available is not clear. This study aimed to examine whether hospitals where cancer patients died offered palliative care.

Association between chronic diseases and severe periodontal disease progression: A retrospective cohort study in a city of Japan.

Background: Chronic periodontal disease primarily causes tooth loss and oral frailty and is linked to chronic conditions such as diabetes mellitus. However, its progression and broader studies on chronic diseases have not been well explored. This study aimed to investigate this association using claims data.

Regional disparities in home health care utilization for older adults and their associated factors at the secondary medical area level: A Nationwide study in Japan.

Aim: As aging populations shift health care from hospitals to communities, Japan has implemented policies to promote home health care. This study explored regional differences in home health care recipients among older adults and related factors.

Methods: We used nationwide data from 2020 to describe the proportion of older adults receiving regular home visits and the medical institutions utilized across secondary medical areas: urban, middle and depopulated areas.

Effects of dementia on functional decline in patients with non-small cell lung cancer at discharge from acute care hospitals: A retrospective cohort study.

Introduction: Hospital admissions often result in functional decline for patients with dementia, yet evidence on the impact of cancer treatments in this population during hospitalization is limited. We aimed to examine the association between dementia and functional decline after cancer treatment in patients with non-small cell lung cancer (NSCLC).

Materials And Methods: A total of 30,213 patients aged 65 years or older hospitalized for NSCLC treatment, from a dataset of 366 acute care hospitals in Japan, were eligible for this study.

Naldemedine for Opioid-Induced Constipation in Patients With Cancer: A Multicenter, Double-Blind, Randomized, Placebo-Controlled Trial.

Purpose: Opioid-induced constipation is the most frequent and non-self-limiting adverse effect of opioid analgesia, reducing adherence and interfering with pain relief. This clinical trial aimed to clarify the preventive effect of naldemedine versus placebo for constipation in patients with cancer starting regularly dosed strong opioids therapy.

Methods: This multicenter, double-blinded, randomized, placebo-controlled, confirmatory trial was conducted between July 2021 and May 2023 at four academic hospitals in Japan (Japan Registry of Clinical Trials identifier: jRCTs031200397).

[Community-Based Comprehensive Care System and Cancer Treatment Coordination System from the Viewpoint of Designated Cancer Hospitals].

In promoting the community-based comprehensive care system, designated cancer hospitals are required to provide decision- making support for treatment and care in the face of increasingly sophisticated and diverse treatments, to promote hospitalization and discharge support to shorten the length of hospital stay, and to implement multidisciplinary cooperation for coordination of treatment and care due to the increasing number of elderly and multi-morbidity cancer patients. However, it is difficult at present to link and integrate designated cancer hospitals, which are required to provide cancer treatment in each secondary medical care area, and community comprehensive care systems, which provide medical care and care to support daily life and autonomy and independence of patients and their families in the patients' living areas. In the future, through the promotion of networking and educational activities for healthcare professionals, as demonstrated in previous studies, it will be necessary to establish a system in which cancer treatment and community-based comprehensive care systems are linked to provide high-quality medical care and care to cancer patients.

Impacts of fluid retention on prognostic abilities of cachexia diagnostic criteria in cancer patients with refractory cachexia.

Background & Aims: The international cancer cachexia criteria with a cutoff of 5% weight loss (WL) was proposed in Western patients. The Asian Working Group for Cachexia (AWGC) developed new criteria in Asian patients. The AWGC criteria are not cancer-specific and employ a cutoff of 2% WL.

Fluid retention and weight loss in refractory cancer cachexia.

Objectives: It is unknown to what extent the fluid retention (FR) status disrupts the detection of weight loss rate (WLR) in adult patients with advanced cancer. This study aimed to determine the association of FR status with WLR.

Methods: This study was a secondary analysis of a prospective cohort study.

Polypharmacy and Potentially Inappropriate Medications in Patients With Advanced Cancer: Prevalence and Associated Factors at the End of Life.

Polypharmacy and potentially inappropriate medications (PIMs) impose a burden on patients with advanced cancer near the end of their lives. However, only a few studies have addressed factors associated with PIMs in such patients. To examine polypharmacy and factors associated with PIMs in end-of-life patients with advanced cancer.

Need for Improvement in Death Pronouncements in Palliative Care Units.

Background: Death pronouncement is an important moment that can impact a family's bereavement process; however, necessary improvements in physicians' behavior during death pronouncement remain unclear.

Objectives: To explore whether the lack of certain behaviors by the physician was associated with a perceived need for improving death pronouncement for advanced cancer patients in palliative care units (PCUs).

Methods: This study was a secondary analysis of a nationwide multicenter questionnaire survey conducted in 2018 that targeted bereaved family members of cancer patients who died in PCUs.

Unresolved Palliative Care Needs of Elderly Non-Cancer Patients at Home: A Multicenter Prospective Study.

Introduction/objectives: There is growing consensus on the benefits of initiating palliative care early in the disease trajectory; however, palliative care needs for non-cancer patients remain to be elucidated. We investigated the trajectory of unresolved palliative care needs of non-cancer patients at home and explored associated factors.

Methods: We conducted a multicenter prospective cohort study of elderly non-cancer patients at home in Japan between Jan 2020 and Dec 2020.

Symptoms and Prognoses of Patients With Breast Cancer and Malignant Wounds in Palliative Care Units: The Multicenter, Prospective, Observational EASED Study.

Background: This study sought to investigate the symptoms and prognoses of patients with breast cancer and malignant wounds in the palliative care unit setting.

Methods: This study was a sub-group analysis of a multicenter, prospective, observational study. Patients admitted to 23 palliative care units in Japan between January and December 2017 were enrolled.

Prediction of Survival in Patients with Advanced Cancer: A Narrative Review and Future Research Priorities.

This paper aimed to summarize the current situation of prognostication for patients with an expected survival of weeks or months, and to clarify future research priorities. Prognostic information is essential for patients, their families, and medical professionals to make end-of-life decisions. The clinician's prediction of survival is often used, but this may be inaccurate and optimistic.