title: 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.
abstract: 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.
authors.affiliation: Japan Cancer Society, Japan Department of Adult Nursing/Palliative Care Nursing, Graduate School of Medicine, The University of Tokyo, and The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Akemi
authors.initials: A
authors.lastname: Yamagishi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Miyashita
authors.forename: Nobuya
authors.initials: N
authors.lastname: Akizuki
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kizawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Shirahige
authors.forename: Miki
authors.initials: M
authors.lastname: Akiyama
authors.lastname: Kei Hirai
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kudo
authors.forename: Takuhiro
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Asuka
authors.initials: A
authors.lastname: Fukushima
authors.forename: Kenji
authors.initials: K
authors.lastname: Eguchi
mesh_terms: D003159:Community-Institutional Relations; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D007564:Japan / Q000453:epidemiology; D017146:Models, Organizational; D009313:National Health Programs / Q000458:organization & administration; D009369:Neoplasms / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010166:Palliative Care / Q000458:organization & administration*; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D011787:Quality of Health Care; D011788:Quality of Life / Q000523:psychology; D012041:Regional Medical Programs / Q000458:organization & administration*; D017749:Total Quality Management / Q000458:organization & administration*