SY13-1 - What is Our Next Step to Improve Region-Based Palliative Care? Lesson from the Optim-Study

Abstract

ABSTRACT Background Palliative care is an essential part of integrated cancer treatment, and should be provided throughout an entire region. The aim of this presentation is to share (i) the main finding of the Outreach Palliative care Trial of Integrated Model (OPTIM study), a mix method regional palliative care intervention study, (ii) review empirical studies about regional palliative care, and (iii) suggest some strategies to improve region-based palliative care in Japan. Methods Study protocol of the OPTIM-study is published as a protocol paper. Results After intervention program implemented, home death significantly increased 6.8% to 10.5% (versus national average of 6.7% to 7.8%), and the ratio of the patients who used specialized palliative care services to cancer death significantly increased 0.31 to 0.50. Family-reported quality of care for terminally ill cancer patients significantly improved (ES, 0.24), while patient-reported quality of palliative care for outpatient cancer patients significantly improved (ES, 0.14). Physician- and nurse-reported difficulties significantly decreased (ES, 0.52, 0.59). Alongside qualitative interview study suggested that increased communication among local health care providers is perceived as the most important change through this intervention. Conclusion The OPTIM-study is completing as one of the largest regional intervention studies in the world, and major finding is generally support pioneer findings. Regional palliative care program would improve quality of palliative care as a region level, and the OPTIMize strategy is proposed. reference Morita T, et al. A region-based palliative care intervention trial using the mixed-method approach: Japan OPTIM study. BMC Palliat Care 2012;11:2. [Epub ahead of print]