Palliative care screening tools in Japan: cross-sectional utility study

Area of Science:

• Gerontology
• Palliative Care
• Health Services Research

Background:

• Japan's population is rapidly aging, increasing demand for palliative care.
• The effectiveness of international palliative care screening tools in Japanese hospitals is not well-established.
• Identifying unmet palliative care needs in acute care settings is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the utility of US-based and UK-based palliative care screening tools in a Japanese acute care hospital.
• To identify the prevalence of unmet palliative care needs among internal medicine inpatients.
• To evaluate the types of comorbid conditions present in patients with palliative care needs.

Main Methods:

• A single-centre, cross-sectional study conducted in Tokyo, Japan (November 2019 - January 2020).
• Utilized the Supportive and Palliative Care Indicator Tool (SPCT) and Palliative Care Screening Tool (PCST).
• Screened patients admitted to an acute care hospital's internal medicine wards.

Main Results:

• 126 patients (51.6%) screened positive for palliative care needs.
• High prevalence of dementia/frailty (85.7%) and neurological disease (50.8%) among positive screens.
• Indicates a significant proportion of inpatients may benefit from palliative care interventions.

Conclusions:

• Approximately half of internal medicine inpatients in acute care settings may have unmet palliative care needs.
• The findings highlight a potential gap in palliative care provision in Japan.
• A modified screening tool may be necessary to efficiently identify high-risk patients given the limited palliative care workforce.