Publications by authors named "Tatsuo Akechi"

Article Synopsis
  • Many cancer patients suffer from psychological distress and low quality of life during or after treatment, facing barriers to accessing support, making digital psychological interventions a potential solution.
  • A comprehensive review of 136 randomized controlled trials identified effective digital interventions including cognitive behavioral therapy (CBT), health education, and virtual reality therapy (VRT), which significantly reduced psychological distress and improved quality of life compared to non-active controls.
  • Digital CBT and VRT were particularly effective in addressing various issues like depression, anxiety, and fatigue, while CBT was the best for insomnia, and mindfulness-based interventions specifically reduced fear of cancer recurrence, highlighting the need for more high-quality trials in this area.
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Article Synopsis
  • Olanzapine is an atypical antipsychotic that helps prevent nausea and vomiting, particularly after highly emetogenic chemotherapy (HEC), but it can cause side effects like hyperglycemia and drowsiness.
  • A systematic review and meta-analysis assessed the effectiveness of olanzapine combined with standard triplet antiemetic therapy compared to triplet therapy alone, focusing on outcomes like nausea control and adverse effects.
  • Results showed that adding olanzapine significantly improved nausea and vomiting prevention in both acute and delayed phases with minimal adverse effects, indicating it can be beneficial for patients undergoing HEC.
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Background: A standardized multi-day antiemetic regimen for multi-day chemotherapy remains elusive. This systematic review evaluated the efficacy and safety of multi-day antiemetic regimens in patients undergoing multi-day intravenous chemotherapy.

Methods: We conducted a comprehensive search of PubMed, Cochrane Library, and Ichushi-Web databases for relevant studies published from January 1990 to December 2020.

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Article Synopsis
  • The study investigated the feasibility and effectiveness of a modified behavioral activation program aimed at helping individuals who have lost loved ones to cancer, specifically in reducing depressive symptoms.
  • The program included a series of pre-interviews and seven 50-minute sessions, with participants showing high completion rates of 95% for the intervention and 90% for follow-up.
  • Results indicated significant reductions in depression and anxiety symptoms, with large effect sizes measured three months post-intervention, suggesting that the program effectively supports bereaved individuals.
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  • Palonosetron is a second-generation anti-nausea drug that might be more effective than first-generation medications, and this study explores how dexamethasone (DEX) works with it during chemotherapy.
  • Researchers compared the effects of giving DEX for 1 day versus 3 days in preventing nausea and vomiting after moderately emetogenic chemotherapy (MEC), using data from studies published between 1990 and 2020.
  • The findings showed that while the 3-day DEX group had a higher rate of no vomiting, there were no major differences in most anti-nausea effects, suggesting that DEX treatment could be shortened to just 1 day when paired with palonosetron.
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Article Synopsis
  • - The study focuses on the effectiveness and safety of dexamethasone-sparing antiemetic therapies, particularly neurokinin-1 antagonists (NKRA), for preventing chemotherapy-induced nausea and vomiting (CINV) in patients undergoing highly emetogenic chemotherapy (HEC).
  • - A systematic review of literature identified and analyzed two studies involving anthracycline-cyclophosphamide and cisplatin-based regimens; while no significant differences in vomiting prevention were found, some outcomes related to nausea showed variability.
  • - The review concludes that dexamethasone-sparing antiemetic therapies can be effective in preventing CINV for HEC, particularly in patients receiving anthracycline-cyclophosphamide
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Background: Chemotherapy-induced nausea and vomiting (CINV) commonly affects patient quality of life and the overall effectiveness of chemotherapy. This study aimed to evaluate whether adding neurokinin-1 receptor antagonists (NK1RAs) to 5-hydroxytryptamine-3 receptor antagonists (5-HTRAs) and corticosteroids provides clinically meaningful benefits in preventing CINV in patients receiving moderately emetogenic chemotherapy (MEC).

Methods: We conducted a systematic review of PubMed, Cochrane Library, and Ichushi-Web to identify clinical studies evaluating NK1RAs combined with 5-HTRAs and dexamethasone for managing CINV in MEC.

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Fear of cancer recurrence (FCR) is a common and distressing condition among adolescents and young adults (AYAs). This study aims to investigate the efficacy of digital interventions, including distress screening-based information provision and smartphone problem-solving therapy, on common psychological distress, especially FCR, in AYA patients with cancer. Participants will be 224 AYA outpatients with cancer aged 15-39 years who will be randomly assigned to either an 8-week smartphone-based intervention or a waitlist control group.

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Context: Home palliative care service increases the chance of dying at home, particularly for patients with advanced cancer, but late referrals to home palliative care services still exist. Indicators for evaluating programs that can facilitate the integration of oncology and home palliative care have not been defined.

Objectives: This study developed quality indicators for the integration of oncology and home palliative care in Japan.

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Background: Prolonged grief disorder (PGD) is a new diagnostic entity. However, treatment for PGD is not yet available. Interpersonal psychotherapy (IPT) may be effective for PGD.

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Aim: Patients' and spouses' neurodevelopmental traits may influence marital relationships, which are significantly associated with depressive symptoms. However, no studies have examined marital relationships in persistent depressive disorder (PDD) in terms of neurodevelopmental traits. This study aimed to explore the association between the autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) traits of female PDD patients and both partners' (patient and husband) marital satisfaction.

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Article Synopsis
  • The study aimed to explore the relationship between patients' unrealistic expectations of chemotherapy as a cure and their understanding of being informed about the incurability of their cancer.
  • Researchers analyzed data from 200 patients with non-small cell lung cancer and found that while most oncologists believed they communicated incurability, many patients did not perceive this disclosure.
  • Patients who maintained unrealistic expectations about chemotherapy were less likely to receive specialized palliative care, indicating a link between understanding their prognosis and the care they received.
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Article Synopsis
  • - The Japan Society of Clinical Oncology updated its 2023 Clinical Practice Guidelines for Antiemesis to incorporate recent findings on antiemetics and cancer treatments, reflecting the latest advancements in the field
  • - A thorough literature search from 1990 to 2020 was conducted to guide the update, leading to the development of 13 background questions, 12 clinical questions, and three future research questions
  • - The updated guidelines aim to enhance understanding and decision-making about antiemetic therapy for both patients and healthcare providers
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Background: Anticipatory chemotherapy-induced nausea and vomiting (CINV) is a conditioned response influenced by the severity and duration of previous emetic responses to chemotherapy. We aimed to evaluate the efficacy of non-pharmacologic interventions for anticipatory CINV among patients with cancer.

Methods: We conducted a systematic search in databases, including PubMed, the Cochrane Library, CINAHL, and Ichushi-Web, from January 1, 1990, to December 31, 2020.

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Importance: Although the cognitive components of behavioral therapy for overactive bladder (OAB) are widely recognized, there is a lack of studies evaluating the effectiveness of multicomponent interventions that include cognitive components as a treatment for OAB.

Objective: To examine the efficacy of a multicomponent intervention in improving health-related quality of life (HRQOL) for women with moderate to severe OAB.

Design, Setting, And Participants: This multicenter, open-label, randomized clinical trial was conducted in Japan among women aged 20 to 80 years who had moderate to severe OAB.

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Article Synopsis
  • * This study implemented a randomized trial involving 359 cancer patients to evaluate the effectiveness of a smartphone app that included various cognitive-behavioral therapy (CBT) skills alongside psychoeducation over eight weeks, using the PHQ-9 questionnaire to measure outcomes.
  • * Results indicated a significant overall reduction in depressive symptoms among participants, but no specific CBT skill showed added benefit over general psychoeducation, leading to the conclusion that specific recommendations for smartphone psychotherapy components cannot be made based on this study.
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Most patients with advanced cancer initially express a desire to be informed of their prognosis, and prognostic discussions between patients and their oncologists can trigger the subsequent trajectory of prognostic cognitions. On the continuum of prognostic cognition, including inaccurate/accurate prognostic awareness (awareness of incurability of cancer, terminal nature of illness or life expectancy) and prognostic acceptance (accepting one's prognosis), patients' perceptions of being informed of their prognosis by oncologists and patients' coping strategy for serious medical conditions regulate prognostic cognitions. However, nearly half of the patients with advanced cancer have poor prognostic awareness, and few patients achieve prognostic acceptance.

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Purpose: Delirium is a common and serious comorbidity in patients with advanced cancer, necessitating effective management. Nonetheless, effective drugs for managing agitated delirium in patients with advanced cancer remain unclear in real-world settings. Thus, the present study aimed to explore an effective pharmacotherapy for this condition.

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Background: End-of-life discussions for patients with advanced cancer are internationally recommended to ensure consistency of end-of-life care with patients' values. This study examined the elements of end-of-life discussions associated with end-of-life care.

Materials And Methods: We performed a prospective observational study among consecutive patients with pretreated non-small cell lung cancer after the failure of first-line chemotherapy.

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Postoperative delirium is an important issue in cancer patients, affecting surgical outcomes and the quality of life. Ramelteon is a melatonin receptor agonist with high affinity for MT1 and MT2 receptors. Clinical trials and observational studies in Japan, including in surgical cancer patients, have shown efficacy of ramelteon in delirium prevention, with no serious safety concerns.

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Background: Cancer patients experience various forms of psychological distress. Their distress, mainly in the form of depression and anxiety, leads to poor quality of life, increased medical spending due to frequent visits, and decrease in treatment adherence. It is estimated that 30-50% among them would require support from mental health professionals: in reality, much less actually receive such support partly due to a shortage of qualified professionals and also due to psychological barriers in seeking such help.

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Background: Burnout and depression among medical students is linked to serious problems that require appropriate solutions. Subthreshold autism traits or autistic-like traits (ALTs) may be possible factors associated with burnout and depression. The effectiveness of acceptance and commitment therapy (ACT) for burnout and depression has been widely reported.

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