Naoto Ishimaru, Yoko Nakazawa, Shunsuke Oyamada, Jun Hamano, Yoshiyuki Kizawa
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引用次数: 0
Abstract
Purpose: Japan has insufficient palliative care specialists, so there are calls for a palliative care consultation system to aid primary care physicians. Community-based palliative care may require clarification on the division of tasks and responsibilities. Primary care physicians' needs specific to palliative care are also ambiguous. We therefore aimed to elucidate the consultation needs of primary care physicians particular to palliative care in Japan.
Methods: This analysis of a nationwide observational study was conducted between December 2023 and January 2024. We sent questionnaires to 1,100 Japanese board-certified primary care physicians based on the Palliative Care Difficulties Scale (range: 1-4). Comparisons were made by unpaired Student's t test and with a multivariate linear regression model according to workplace type (clinics and hospitals).
Results: We obtained 548 replies (response rate: 50%), of which 540 had analyzable data. Primary care physicians in clinics required less consultation than those in hospitals on the choice of medication (P = .019), opioids switching (P = .018), prognosis estimates (P < .001), decision support (P = .016), and grief care (P = .009). Those in clinics were less likely to have palliative care support from non-physician palliative care specialists (P < .001) and information support (P = .003). In multivariable analysis, being a clinic-based physician was inversely associated with the functioning of a decision-making support counseling system (R2 = 0.527).
Conclusions: The specific consultation needs of primary care physicians in Japan specific to palliative care differ by workplace. Our data suggest the need for clear national-level supporting guidelines and training toward primary care physicians' involvement in palliative care and individualized end-of-life management.UMIN trial ID: UMIN000054985.
期刊介绍:
Family Practice is an international journal aimed at practitioners, teachers, and researchers in the fields of family medicine, general practice, and primary care in both developed and developing countries.
Family Practice offers its readership an international view of the problems and preoccupations in the field, while providing a medium of instruction and exploration.
The journal''s range and content covers such areas as health care delivery, epidemiology, public health, and clinical case studies. The journal aims to be interdisciplinary and contributions from other disciplines of medicine and social science are always welcomed.