Clinical pathways can improve the quality of pain management in home palliative care in remote locations: retrospective study on Kozu Island, Japan

Tateno, Yuki; Ishikawa, Shizukiyo

doi:10.22605/rrh1992

Cited by 8 publications

(8 citation statements)

References 18 publications

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“…Table 1 shows the selected characteristics of the 66 studies from 1994 to 2020 1,4–23,25–67 . Considering the whole period, the weighted mean of negative PMI decreased from 47% to 40%.…”

Section: Resultsmentioning

confidence: 99%

“…1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Considering the whole period, the weighted mean of negative PMI decreased from 47% to 40%. The Asian studie s 26,[30][31][32][40][41][42]44,45,52,53,57,63,66 reported the highest rate of negative PMI from 1994 to 2013 (59% and 42% respectively), while the USA studies 13,15,19 from 2014 to 2020 (42%). The negative PMI decrease from 1994 to 2020 in the specific setting of care for cancer pain (from 52% to 40% respectively).…”

Section: R E Su Lt Smentioning

confidence: 99%

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Living systematic review to assess the analgesic undertreatment in cancer patients

et al. 2022

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Background and aims This living and systematic review aimed to provide an updated summary of the available evidence on pain undertreatment prevalence in patients with cancer; correlations with some potential determinants and confounders were also carried out. Materials and methods We updated a systematic review published on 2014, including observational and experimental studies reporting the use of the pain management index (PMI) in adults with cancer and pain, from 2014 to 2020. We conducted searches in PubMed/MEDLINE, Embase, and Google Scholar. We performed univariate and multivariable regression analyses to describe the relationship between PMI and a list of potential explanatory variables. Results Twenty new papers were identified, yielding a total sample size of 66 studies. The proportion of patients classified as undertreated according to the year of study publication shows a higher decrease from 1994 to 2013 (−13% as relative change) than the most recent years 2014–2020 (−11%). The quality of the included studies has increased over the years (from 80% to 93%). At the multivariable analysis, a statistically significant relationship was confirmed between undertreatment and the year of the publication of the study and with a low–medium economic level of the countries, where the studies were conducted. Discussion Despite the improvement when compared to the period 1994–2000, still about 40% of the cases identified received an analgesic treatment inadequate to the intensity of pain, according to the PMI. Despite its intrinsic limitations, PMI continues to be widely used, and it could allow a continuous monitoring of pain management across a different mix of studies and patients.

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Section: Resultsmentioning

confidence: 99%

Section: R E Su Lt Smentioning

confidence: 99%

Living systematic review to assess the analgesic undertreatment in cancer patients

et al. 2022

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“…The use of a clinical pathway has been shown to be a general trend in the realization of at-home death [ 7 , 11 ]. This was supported by the results in the present study on rural clinics.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the increasing number of at-home death as the population ages [ 3 ], a minority of deaths take place at home in the real-world [ 4 , 5 ]. As a general trend, palliative care instruction, the presence of clinical pathways, and the provision of at-home palliative care services can increase the chance of at-home death for cancer patients [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…As the number of hospitals is limited, clinics have roles in cancer treatment and palliative care in rural areas. Were the factors related to at-home death for cancer patients in rural areas similar to the above-mentioned general trends [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ] in relation to the realization of at-home death for cancer patients? Since this remains unknown, the aim of the present study was to investigate the possible predictors of at-home death for cancer patients in rural clinics in Japan.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of At-Home Death for Cancer Patients in Rural Clinics in Japan

Watanabe

Teraura

Komatsu

et al. 2021

IJERPH

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Background: The prediction of at-home deaths has become an important topic in rural areas of Japan with an advanced aging society. However, there are no well-established predictors to explain how these factors influence intention. This study aims to investigate the possible predictors of at-home death for cancer patients in rural clinics in Japan. Methods: This is a nationwide cross-sectional survey. A self-administered questionnaire was sent to 493 rural clinics in Japan. The main outcome was the realization of at-home deaths for cancer patients. Results: Among the 264 clinics (54%) that responded to the survey, there were 194 clinics with the realization of at-home death. The use of a clinical pathway (adjusted odds ratio 4.19; 95% confidence interval 1.57–11.19) and the provision of organized palliative care (adjusted odds ratio 19.16; 95% confidence interval 7.56–48.52) were associated with the prediction of at-home death, irrespective of island geography or the number of doctors and nurses. Conclusions: Having a clinical pathway and systematizing palliative care could be important to determine the possibility of at-home deaths for cancer patients in rural clinics in Japan.

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