Annual Report 2018
Department of Psycho-Oncology Service
Asao Ogawa, Masanori Enokido, Yusei Iwata, Daisuke Fujisawa, Mayumi Takahashi
Introduction
The aim of the Department of Psychooncology Service is to develop mind-centered interventions to restore, maintain, and improve the quality of life of patients and their families throughout cancer treatment, and in the endof-life period. Our Service has focused on developing effective interventions for delirium, dementia, and depression in cancer patients as well as on determining the mechanism underlying the relationship between cancer and the mind through a combination of neuropsychiatric, psychosocial, and behavioral sciences.
Especially, increases in the number of individuals diagnosed with cancer each year, due in large part to the growth of the aging population, as well as improving survival rates have led to an ever-increasing number of elderly cancer patients with deteriorating cognitive functions. Thus, we conduct research on the development and validation of geriatric assessment such as minicog, comprehensive geriatric assessment (CGA) and so on, and the evaluation of effectiveness about multidisciplinary interventions among hospitalized cancer patients with delirium or cognitive function disorder including mild cognitive impairment.
The Team and What We Do
The Department of Psycho-oncology Service is composed of three attending psychiatrists and three clinical psychologists. The clinical activity includes psychiatric consultation involving comprehensive assessment and the addressing of psychiatric problems of cancer patients. The patients are either self-referred or referred by their oncologist in charge. The consultation data are shown in table 1. Psychiatric diagnosis is based on the DSM-5 (Diagnostic and Statistical Manual of Mental Disorder, 5th edition) criteria. Consultation data also include individuals who are family members of cancer patients.
A conference with the Supportive Care Team is held every Wednesday, and a multicenter joint clinical tele-conference involving six cancer center hospitals and three university hospitals is held every Thursday.
Table 1. Psychiatric consultation data (n=1,272; April, 2018-May, 2019)
Research activities
1. A multi-center, cluster randomized controlled study comparing usual care and multidisciplinary interventions such as DELirium Team Approach-program (DELTA program) to prevent the development and severity of delirium among hospitalized cancer patients (Research and Development grants for cancer at the Japan Agency for Medical Research and Development)
Delirium, defined as an acute disorder of attention and global cognitive function, is a common, serious, and potentially preventable source of morbidity and mortality for hospitalized elderly people. The primary prevention, preventing delirium before it develops, is the most effective strategy for reducing delirium. We reported the effectiveness of multidisciplinary intervention to prevent the development and severity of delirium among hospitalized patients designed by a multi-center, cluster randomized controlled study.
2. Development of a support program for people with dementia in general hospital settings as a multidisciplinary intervention for treatment and care of physical complications and dementia (Research and Development grants for cancer at the Japan Agency for Medical Research and Development)
With the growing number of elderly people, the prevalence of dementia with physical and mental conditions at acute hospitals has increased. The purpose of this study is to develop a support program for people with dementia in acute hospital settings as a multidisciplinary intervention for treatment and care dementia to establish multiple access points in the dementia care pathway in Japan.
We reported the educational effects of dementia care for acute hospital nurses and plan to evaluate the clinical effects.
List of papers published in 2018
Journal
1. Okuyama T, Yoshiuchi K, Ogawa A, Iwase S, Yokomichi N, Sakashita A, Tagami K, Uemura K, Nakahara R, Akechi T. Current Pharmacotherapy Does Not Improve Severity of Hypoactive Delirium in Patients with Advanced Cancer: Pharmacological Audit Study of Safety and Efficacy in Real World (Phase-R). Oncologist, 2019
2. Takeuchi E, Shimizu M, Miyata K, Shimizu R, Matsunaga N, Moroi N, Fujisawa D, Mimura M, Kato M. A Content Analysis of Multidimensional Support Needs Regarding Fertility Among Cancer Patients: How Can Nonphysician Health Care Providers Support? J Adolesc Young Adult Oncol, 8:205-211, 2019
3. Ogawa A, Okumura Y, Fujisawa D, Takei H, Sasaki C, Hirai K, Kanno Y, Higa K, Ichida Y, Sekimoto A, Asanuma C. Quality of care in hospitalized cancer patients before and after implementation of a systematic prevention program for delirium: the DELTA exploratory trial. Support Care Cancer, 27:557-565, 2019
4. Kako J, Kobayashi M, Kanno Y, Ogawa A, Miura T, Matsumoto Y. The Optimal Cutoff Point for Expressing Revised Edmonton Symptom Assessment System Scores as Binary Data Indicating the Presence or Absence of Symptoms. Am J Hosp Palliat Care, 35:1390-1393, 2018
5. Takeuchi E, Kato M, Miyata K, Suzuki N, Shimizu C, Okada H, Matsunaga N, Shimizu M, Moroi N, Fujisawa D, Mimura M, Miyoshi Y. The effects of an educational program for non-physician health care providers regarding fertility preservation. Support Care Cancer, 26:3447-3452, 2018
6. Ogawa A, Kondo K, Takei H, Fujisawa D, Ohe Y, Akechi T. Decision-Making Capacity for Chemotherapy and Associated Factors in Newly Diagnosed Patients with Lung Cancer. Oncologist, 23:489-495, 2018
7. Nakanishi M, Okumura Y, Ogawa A. Physical restraint to patients with dementia in acute physical care settings: effect of the financial incentive to acute care hospitals. Int Psychogeriatr, 30:991- 1000, 2018
8. Sakata N, Okumura Y, Fushimi K, Nakanishi M, Ogawa A. Dementia and Risk of 30-Day Readmission in Older Adults After Discharge from Acute Care Hospitals. J Am Geriatr Soc, 66:871- 878, 2018
9. Kubo H, Urata H, Katsuki R, Hirashima M, Ueno S, Suzuki Y, Fujisawa D, Hashimoto N, Kobara K, Cho T, Mitsui T, Kanba S, Otsuka K, Kato TA. Development of MHFA-based 2-h educational program for early intervention in depression among office workers: A single-arm pilot trial. PLoS ONE, 13:e0208114, 2018
10. Sado M, Park S, Ninomiya A, Sato Y, Fujisawa D, Shirahase J, Mimura M. Feasibility study of mindfulness-based cognitive therapy for anxiety disorders in a Japanese setting. BMC Res Notes, 11:653, 2018
11. Sato T, Soejima K, Fujisawa D, Takeuchi M, Arai D, Nakachi I, Naoki K, Kawada I, Yasuda H, Ishioka K, Nukaga S, Kobayashi K, Masaki K, Inoue T, Hikima K, Nakamura M, Ohgino K, Oyamada Y, Funatsu Y, Terashima T, Miyao N, Sayama K, Saito F, Sakamaki F, Betsuyaku T. Prognostic Understanding at Diagnosis and Associated Factors in Patients with Advanced Lung Cancer and Their Caregivers. Oncologist, 23:1218-1229, 2018
12. Aoyama M, Sakaguchi Y, Morita T, Ogawa A, Fujisawa D, Kizawa Y, Tsuneto S, Shima Y, Miyashita M. Factors associated with possible complicated grief and major depressive disorders. Psychooncology, 27:915-921, 2018
13. Park S, Sado M, Fujisawa D, Sato Y, Takeuchi M, Ninomiya A, Takahashi M, Yoshimura K, Jinno H, Takeda Y. Mindfulness-based cognitive therapy for Japanese breast cancer patients-a feasibility study. Jpn J Clin Oncol, 48:68-74, 2018
14. Kaibori M, Nagashima F, Ogawa A. Resection versus radiofrequency ablation for hepatocellular carcinoma in elderly patients in a Japanese nationwide cohort. Ann Surg