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Palliative Care in Japan: Current Status and a Nationwide Challenge to Improve Palliative Care by the Cancer Control Act and the Outreach Palliative Care Trial of Integrated Regional Model (OPTIM) Study

Japan Cancer Society, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Adult Nursing/ Palliative Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo

Tatsuya Morita, MD

Department of Palliative and Supportive Care, Palliative Care Team, and Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, tmorita{at}sis.seirei.or.jp

Mitsunori Miyashita, RN, PhD

Japan Department of Adult Nursing/ Palliative Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo

Nobuya Akizuki, MD, PhD

Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba

Yoshiyuki Kizawa, MD

Shirahige Clinic, Nagasaki

Yutaka Shirahige, MD, PhD

Graduate School of Comprehensive Human Science, University of Tsukuba, Ibaraki

Miki Akiyama, PhD

Faculty of Policy Management, Keio University, Kanagawa

Kei Hirai, PhD

Center for the Study of Communication-Design, Department of Complementary and Alternative Medicine, Graduate School of Medicine, The University of Osaka, Osaka

Tadashi Kudo, MA

Graduate School of Comprehensive Human Science, University of Tsukuba, Ibaraki

Takuhiro Yamaguchi, PhD

Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo Hospital, Tokyo

Asuka Fukushima, RN

Japan Cancer Society, g, Graduate School of Medicine, The University of Tokyo, Tokyo, Division of Medical Oncology, Teikyo University School of Medicine, Tokyo, Japan

Kenji Eguchi, MD, PhD

Division of Medical Oncology, Teikyo University School of Medicine, Tokyo, Japan

Palliative care is an essential part of integrated cancer treatment. To improve palliative care throughout Japan, a nationwide demonstration project, the Outreach Palliative Care Trial of Integrated Regional Model (OPTIM) study, is ongoing. This article reviews the current status and the problems of palliative care in Japan and introduces the OPTIM study. Although the number of palliative care services is increasing, empirical evidence shows the quality of life of cancer patients is still inadequate. The OPTIM study is an intervention trial targeting 4 areas across Japan. Primary end points are quality of care reported by patients as well as the bereaved family, number of patients who received specialized palliative care services, and place of death. The interventions are comprehensively designed to cover all areas identified by the national task force. The OPTIM study will contribute to improve patients' quality of life by proposing a regional palliative care model suitable for Japan.

Key Words: palliative care • regional trial • neoplasms

This version was published on October 1, 2008

American Journal of Hospice and Palliative Medicine®, Vol. 25, No. 5, 412-418 (2008)
DOI: 10.1177/1049909108318568


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