Journal of Japanese Society for Clinical Pathway
Online ISSN : 2436-1046
Print ISSN : 2187-6592
Study Report
Considerations for improving a prostate cancer liaison/clinical pathway system based on a questionnaire survey of patients and liaison medical facilities
Yutaka TakezawaTatsuhiro SawadaYuji FujizukaTakeaki MakinoToru EtsunagaYoshitaka SaitoMikio Kobayashi
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JOURNAL FREE ACCESS

2020 Volume 22 Issue 2 Pages 77-84

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Abstract

 We created a liaison/clinical pathway system in cooperation with local medical facilities to follow up with patients who had undergone radical prostate cancer treatment. In this study, we sought to evaluate the liaison/clinical pathway using a questionnaire survey of patients and liaison facilities. The study population comprised 378 patients who were contacted periodically for ≥1 year and 184 liaison facilities. Responses were received from 322 patients and 108 facilities. Patients assessed the liaison/clinical pathway as follows: “satisfied” (61%), “hard to tell” (34%) and “unsatisfied” (5%). Comorbidities were observed in 63% of patients. However, only 48% of the comorbidities were treated by the liaison facilities. Advantages of the liaison/clinical pathway system included reduced travel time to medical facilities and outpatient wait time, and the possibility of receiving treatment for other diseases. Problems identified included, “this hospital should conduct the follow-up”, and “apprehension about being treated by non-specialists”. Although 86% of the physicians at the liaison facilities were not urologists, 91% of patients reported that this was not a problem. Only 58% of the facilities were within the scope of the liaison guidance fee for cancer treatment. Most patients and liaison facilities supported a one-year liaison cycle/clinical pathway system. Patient satisfaction was somewhat lower than has been reported in previous studies. This may be attributable to treatment of comorbidities at facilities other than the liaison facilities, strong patient preference for core hospitals, apprehension about treatment by non-specialists and limitation of the scope of the follow-up under the liaison/clinical pathway system to patients who have received radical treatment. Future challenges include reconsideration of the method of selecting liaison facilities, medical care that can reduce patient apprehension, inclusion of endocrine treatments in the scope of the liaison/clinical pathway and an improved system for calculating liaison guidance fees for cancer treatment.

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© 2020 Japanese Society for Clinical Pathway
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