Cancer care for people with mental disorders: A qualitative survey among cancer care and psychiatric care professionals in Japan

Etoh, Tsuyoshi; Fujiwara, Masaki; Yamada, Yuto; Wada, Riho; Higuchi, Yuji; Inoue, Shin‐ichiro; Kodama, Masafumi; Matsushita, Takanori; Yoshimura, Yusaku; Horii, Shigeo; Fujimori, Maiko; Kakeda, Kyoko; Shimazu, Taichi; Nakaya, Naoki; Tabata, Masahiro; Uchitomi, Yosuke; Yamada, Norihito; Inagaki, Masumi

doi:10.1002/pon.5780

Cited by 6 publications

(39 citation statements)

References 39 publications

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“…Further effort is necessary to promote collaborations between cancer care providers and primary psychiatric care/welfare services. One solution may be to offer specific cancer care support for people with disabilities, including mental disorders, as part of patient support or palliative care centers at designated cancer hospitals 15 . Another solution is to establish region‐wide programs, which include case review meetings, which promote collaborative treatment for cancer patients with mental illnesses 15 …”

Section: Discussionmentioning

confidence: 99%

“…14 To identify issues of cancer treatment in people with mental disorders, we previously conducted a qualitative survey in multidisciplinary healthcare professionals. 15 In the survey, we extracted the following issues faced by cancer care providers: 'cancer health care professional's knowledge and attitude towards people with mental disorders'; 'coordination between psychiatric care professionals and cancer care professionals'; and 'the issue of designated cancer hospitals.' It remains unclear which issues are perceived by cancer care providers as difficult/insufficient.…”

Section: Introductionmentioning

confidence: 99%

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Issues of cancer care in people with mental disorders as perceived by cancer care providers: A quantitative questionnaire survey

et al. 2022

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Objectives To reduce cancer care disparities, this study aimed to clarify the difficulties in cancer care for people with mental disorders as perceived by cancer care providers. Methods Cancer care providers at 17 designated cancer hospitals in Japan were surveyed using mail questionnaires. Respondents were asked to rate 29 items related to difficulties or insufficiencies in cancer care for patients with mental disorders on a five‐point Likert scale. We analyzed the proportion of respondents who answered “difficult/insufficient” in each item. We also calculated the proportions of responders stratified according to the presence of psychiatric support systems within their hospitals. Results A total of 388 (58.4%) cancer care providers responded. Among the issues related to “difficulties in diagnosing and treating cancer,” support for decision‐making, assessment of treatment adherence, and assessment of physical symptoms were perceived as most difficult (73.5%–81.5% of respondents). Among the issues related to ‘difficulties or insufficiencies in collaboration among multidisciplinary health care providers,’ the issue of advance consultation and sharing information with the patient's primary psychiatric care provider was perceived as most difficult (52.2%). Among the issues related to “insufficiencies of in‐hospital and community medical systems,” education to provide reasonable accommodation was perceived as most insufficient (47.4%). The perceived difficulties of over half of the issues varied significantly between hospitals depending on the level of psychiatric support systems. Conclusions This study clarified the difficulties of cancer care in patients with mental disorders as perceived by cancer care providers. Some issues may be resolved by psychiatric liaison teams.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Issues of cancer care in people with mental disorders as perceived by cancer care providers: A quantitative questionnaire survey

et al. 2022

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“…The study found that there were barriers to cancer care provision for patients affected by SMI: fragmentation of care; healthcare providers' understanding of SMI; complex nature of presentation; and specialized care needs. In a Japanese study, by analyzing the responses of 439 professionals, Etoh et al 23 A very specific and important point was raised by McFarland et al 25 in the USA. In a series of psychiatric consultations for patients with SMI and cancer, they found that shared decision making was often a problem.…”

Section: Stigma Marginalization and Communication Problemsmentioning

confidence: 99%

“…The study found that there were barriers to cancer care provision for patients affected by SMI: fragmentation of care; healthcare providers' understanding of SMI; complex nature of presentation; and specialized care needs. In a Japanese study, by analyzing the responses of 439 professionals, Etoh et al 23 . categorized issues related to communication barriers into a series of dimensions: patient factors; isolation and lack of support; attitudes of both psychiatry and cancer care professionals.…”

Section: Overview Of the Special Issue Contentmentioning

confidence: 99%

Disparities and inequalities in cancer care and outcomes in patients with severe mental illness: Call to action

Grassi

Riba

2021

Psycho-Oncology

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Objectives: People with severe mental illness (SMI) are at extreme risk of being stigmatized and to receive poor quality physical care. It has been demonstrated that they have higher morbidity and poorer prognosis of several medical diseases than the general population, with an at least 10-20-year reduction in life expectancy. Methods: A special issue of Psycho-Oncology focusing on cancer care among patients affected by SMI was called by the Editorial Board of the journal, with the aim to explore cancer health disparities and inequalities among people with SMI, mortality from cancer, problems of communication between multidisciplinary oncology and psychiatric teams and need for more structured intervention (i.e., screening, prevention, treatment). Results: Authors from eight countries contributed. The problem of stigma and barriers to cancer care provision for patients with SMI were studied (e.g., the complex nature of SMI and healthcare providers' misunderstanding of SMI). Key barriers were related to both patients, clinicians and institutional problems, such as fragmentation of care. A higher mortality from cancer and poor knowledge about cancer risk-factors was shown in patients with SMI. Models of intervention were also proposed. Conclusions: Several conclusions have been recommended by the authors, such as the need for guidelines and clinical procedures specific for cancer care in mental health settings; large-scale studies to address the disparities of care in people with SMI; a larger vision of psychosocial oncology as the facilitator of the liaison between oncology and psychiatry.

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“…For example, patients may experience diagnosis or treatment delays, have difficulties in adhering to or receipt of appropriate cancer treatment because of the symptoms of mental disorders. 8,9 Poorer adherence could lead to those individuals with PMHD not being allocated to recommended treatment pathways. Therefore, the important questions about the management of cancer in the context of PMHD are to what extent patients experience treatment delays or receive different/less effective treatment regimens compared to those without PMHD.…”

Section: Introductionmentioning

confidence: 99%

Impact of pre‐existing mental health disorders on the receipt of guideline recommended cancer treatments: A systematic review

et al. 2023

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Objective: Disparities in cancer outcomes for individuals with pre-existing mental health disorders have already been identified, particularly for cancer screening and mortality. We aimed to systematically review the influence on the time from cancer diagnosis to cancer treatment, treatment adherence, and differences in receipt of guideline recommended cancer treatment. Methods:We included international studies published in English from 1 January 1995 to 23 May 2022 by searching MEDLINE, Embase, and APA PsycInfo.Results: This review identified 29 studies with 27 being published in the past decade. Most studies focused on breast, non-small cell lung and colorectal cancer and were of high or medium quality as assessed by the Newcastle Ottawa Scale. All studies were from high-income countries, and mostly included patients enrolled in national health insurance systems. Five assessed the impact on treatment delay or adherence, and 25 focused on the receipt of guideline recommended treatment. 20/ 25 studies demonstrated evidence that patients with pre-existing mental health disorders were less likely to receive guideline recommended therapies such as surgery or radiotherapy. In addition, there was a greater likelihood of receiving less intensive or modified treatment including systemic therapy.Conclusions: Across different cancer types and treatment modalities there is evidence of a clear disparity in the receipt of guideline recommended cancer treatment for patients with pre-existing mental health disorders. The effect of pre-existing mental health disorders on treatment delay or adherence is under-researched.Future research needs to include low-and middle-income countries as well as qualitative investigations to understand the reasons for disparities in cancer treatment.

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Cancer care for people with mental disorders: A qualitative survey among cancer care and psychiatric care professionals in Japan

Cited by 6 publications

References 39 publications

Issues of cancer care in people with mental disorders as perceived by cancer care providers: A quantitative questionnaire survey

Issues of cancer care in people with mental disorders as perceived by cancer care providers: A quantitative questionnaire survey

Disparities and inequalities in cancer care and outcomes in patients with severe mental illness: Call to action

Impact of pre‐existing mental health disorders on the receipt of guideline recommended cancer treatments: A systematic review

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