Abstract
Recently, the numbers of patients with prostate cancer are increasing as well as the proportion of the examination time at outpatient clinics. This is leading to an extension of not only clinic hours but also of patients' waiting time. To improve this situation and reduce the burden on patients, the Toyota Memorial Hospital attempted to introduce a liaison critical pathway for stable patients with prostate cancer in hormonal therapy. Indications of the critical pathway are：1) the patient is in hormonal therapy, 2) the patient's PSA level is below 0.2ng/ml, 3) the patient is well aware of the side effects of the hormonal therapy and 4) the patient is meeting the above criteria and is in stable condition since over 3 months. Home doctors were then requested to treat patients continually after the hospital's referral, refer them back to the hospital if their PSA level increases above 0.5ng/ml and patients were required to visit the hospital once a year in their birthday month regardless of their PSA level. 28 patients participated in this pathway over the period from February 2008 to January 2009. Results were verified in a questionnaire, which had been given to the home doctors and showed that the pathway is manageable and useful.
