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.

　To clarify the results of the regional cooperation critical pathway for diabetes mellitus (hereinafter referred to as the “DM pathway”), factors related to the reduction and maintenance of glycemic control associated with diabetes mellitus were analyzed. 74 patients who visited our DM pathway outpatient clinic between 2004 and 2016 were examined. The factors assessed were gender, age at the start of the DM pathway, HbA1c, antidiabetic drugs being used, instructions provided by pharmacists, number of years of consultation with the DM pathway and diabetes mellitus classification. Patients using insulin alone were grouped with those using insulin with oral hypoglycemic agents (OHAs) and classified as the insulin (INS) group, while patients using OHA alone were grouped with those using no insulin and classified as the OHA group. The primary endpoint was the time at which a patient introduced to the DM pathway achieved HbA1c <7% twice in succession. The relationship between the primary endpoint and each factor was examined using a survival time analysis. Therapeutic agents were the only factors affecting the achievement rate. The hazard ratio for achievement was 0.47 (95% confidence interval: 0.23-0.97) in the INS group compared to the OHA group. Patients using insulin had lower HbA1c reduction and maintenance achievement rates and showed longer achievement times than patients using OHA alone. Aggressive interventions in patients using insulin may be a modifiable factor. Future challenges include establishing an improved regional cooperation pathway that includes insurance pharmacies. This will require sharing the contents of the instructions provided by our pharmacists and problems with the DM pathway and facilitating cooperation between core hospitals and clinics in the relevant areas, as well as cooperation between hospital pharmacists and community pharmacists.