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• Associations of nutrition impact symptoms with depression in patients with advanced cancer

  Amano, K; Okamura, S; Matsuda, Y; Baracos, VE; Mori, N; Miura, T; Tatara, R; Kessoku, T; Tagami, K; Otani, H; Mori, M; Taniyama, T; Nakajima, N; Nakanishi, E; Kako, J; Morita, T; Miyashita, M

  SUPPORTIVE CARE IN CANCER ( Supportive Care in Cancer )  32 ( 7 ) 445 - 445   2024年07月 [ 査読有り ]

  掲載種別: 研究論文（学術雑誌）

  　概要を見る

  PURPOSE: Advanced cancer patients have nutrition impact symptoms (NISs), while many of them have depressive moods. This study aimed to determine the associations of NISs with depression. METHODS: This study was a secondary analysis. The dietary intake and 19 NISs in patients receiving palliative care were evaluated using 10-point scales, and the patients were categorized into two groups (non-depression and depression groups) using the cutoff based on the Patient Health Questionnaire-9 (PHQ-9). To determine associations between depression and the number of NISs with a score of ≥ 4, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the logistic regression model were calculated. RESULTS: A total of 225 participants were divided into the non-depression group (n = 148) and the depression group (n = 77). The prevalence of depression was 34.2%. Dietary intake was lower, and the number of NISs with a score of ≥ 4 was higher in the depression group (both p < 0.001). All NISs were more severe in the depression group. Significant differences were observed in 15 of the 19 NISs. In the logistic regression model, significantly higher adjusted ORs were observed in the groups with 4-6 NISs and 7 or more NISs with a score of ≥ 4 (10.76 [95% CI, 2.07-55.91], p = 0.016; 17.02 [95% CI, 3.08-94.22], p < 0.001) than in the group with no NISs with a score of ≥ 4. CONCLUSION: Having four or more NISs with a score ≥ 4 was associated with depression.

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• Associations of nutrition impact symptoms with dietary intake and eating-related distress in patients with advanced cancer

  Amano, K; Baracos, VE; Mori, N; Okamura, S; Yamada, T; Miura, T; Tatara, R; Kessoku, T; Matsuda, Y; Tagami, K; Otani, H; Mori, M; Taniyama, T; Nakajima, N; Nakanishi, E; Kako, J; Morita, T; Miyashita, M

  CLINICAL NUTRITION ESPEN ( Clinical Nutrition ESPEN )  60   313 - 319   2024年04月 [ 査読有り ]

  掲載種別: 研究論文（学術雑誌）

  　概要を見る

  BACKGROUND & AIMS: There is no definition of nutrition impact symptoms (NISs) in cancer care. Moreover, there is a lack of evidence on the associations of NISs with dietary intake and eating-related distress (ERD) in advanced cancer. Therefore, this study aimed to determine the associations of NISs with dietary intake and ERD in patients with advanced cancer. METHODS: This study entailed a secondary analysis of a multicenter self-reported questionnaire designed to develop measurements that assess ERD experienced by patients. Participants evaluated their dietary intake and 19 symptoms regarded as NISs using a 10-point scale. To determine the association between dietary intake and the number of NISs with a score ≥4, estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the logistic regression model were calculated. Furthermore, to assess the association between ERD and the number of NISs with a score ≥4, multiple regression analysis was performed. RESULTS: A total of 302 patients were included in the analysis. The higher the number of NISs with a score ≥4, the lower the dietary intake tended to be. In the logistic regression model, significantly higher adjusted ORs than in the no NISs with a score ≥4 group were observed in the 4-6 NISs group, 7-9 NISs group, and 10 or more group (0.19 [95% CI, 0.07-0.52], p = 0.001; 0.11 [95% CI, 0.03-0.42], p = 0.001; 0.07 [95% CI, 0.01-0.36], p = 0.002, respectively). In the multiple regression analysis, the number of NISs with a score ≥4 was identified as one of the factors significantly associated with ERD. CONCLUSIONS: Having 4 or more NISs with a score ≥4 was shown to be predictive of the likelihood of reduced dietary intake. Furthermore, the higher the number of NISs with a score ≥4, the more likely the eating-related quality of life was impaired in advanced cancer.

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• Effectiveness of antipsychotics for managing agitated delirium in patients with advanced cancer: a secondary analysis of a multicenter prospective observational study in Japan (Phase-R)

  Kurisu, K; Inada, S; Maeda, I; Nobata, H; Ogawa, A; Iwase, S; Uchida, M; Akechi, T; Amano, K; Nakajima, N; Morita, T; Sumitani, M; Yoshiuchi, K

  SUPPORTIVE CARE IN CANCER ( Supportive Care in Cancer )  32 ( 3 ) 147 - 147   2024年03月 [ 査読有り ]

  掲載種別: 研究論文（学術雑誌）

  　概要を見る

  PURPOSE: Delirium is a common and serious comorbidity in patients with advanced cancer, necessitating effective management. Nonetheless, effective drugs for managing agitated delirium in patients with advanced cancer remain unclear in real-world settings. Thus, the present study aimed to explore an effective pharmacotherapy for this condition. METHODS: We conducted a secondary analysis of a multicenter prospective observational study in Japan. The analysis included patients with advanced cancer who presented with agitated delirium and received pharmacotherapy. Agitation was defined as a score of the Richmond Agitation-Sedation Scale for palliative care (RASS-PAL) of ≥ 1. The outcome was defined as -2 ≤ RASS-PAL ≤ 0 at 72 h after the initiation of pharmacotherapy. Multiple propensity scores were quantified using a multinomial logistic regression model, and adjusted odds ratios (ORs) were calculated for haloperidol, chlorpromazine, olanzapine, quetiapine, and risperidone. RESULTS: The analysis included 271 patients with agitated delirium, and 87 (32%) showed -2 ≤ RASS-PAL ≤ 0 on day 3. The propensity score-adjusted OR of olanzapine was statistically significant (OR, 2.91; 95% confidence interval, 1.12 to 7.80; P = 0.030). CONCLUSIONS: The findings suggest that olanzapine may effectively improve delirium agitation in patients with advanced cancer.

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• Anticholinergic drugs for death rattle in dying patients with cancer: multicentre prospective cohort study

  Yamaguchi, T; Yokomichi, N; Yamaguchi, T; Maeda, I; Matsunuma, R; Tanaka-Yagi, Y; Akatani, A; Suzuki, K; Kohara, H; Taniyama, T; Matsuda, Y; Nakajima, N; Morita, T; Tsuneto, S; Mori, M

  BMJ SUPPORTIVE & PALLIATIVE CARE ( BMJ Supportive and Palliative Care )  13 ( 4 ) 462 - 471   2023年12月 [ 査読有り ]

  掲載種別: 研究論文（学術雑誌）

  　概要を見る

  BACKGROUND: This study aimed to investigate the effectiveness of anticholinergics (AC) for death rattle in dying patients with cancer. METHODS: This is a prospective cohort study enrolled Terminally ill adult (20 years or older) patients with cancer who developed substantial death rattle (Back score ≥2) from 23 palliative care units in Japan. AC treatment for death rattle was prescribed according to primary physician's decision. The primary outcome was the proportion of patients whose death rattle improved, which was defined as a Back score of ≤1. We compared the proportion of improved cases in patients treated with (AC group) and without (non-AC group) AC, controlling potential confounders by employing propensity score weighting. RESULTS: Of the 1896 patients enrolled, we included 196 who developed a substantial death rattle. Of these, 81 received AC. 56.8% in the AC group and 35.4% in the non-AC group had an improved death rattle at 8 hours after baseline. In the weighted analysis, AC group showed significant improvements in death rattle, with an adjusted OR of 4.47 (95% CI 2.04 to 9.78; p=0.0024). All sensitivity analyses achieved essentially the same results. In the subgroup analysis, ACs were strongly associated with death rattle improvement in men, patients with lung cancer, and type 1 death rattle (adjusted OR 5.81, 8.38 and 9.32, respectively). CONCLUSIONS: In this propensity score-weighted analysis, ACs were associated with death rattle improvement in terminally ill patients with cancer who developed substantial death rattle. TRIAL REGISTRATION NUMBER: UMIN-CTR (UMIN00002545).

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• Difficulty swallowing and food bolus obstruction in advanced cancer: association with the cachexia-related quality of life.

  Otani H, Amano K, Morita T, Miura T, Mori N, Tatara R, Kessoku T, Tokoro A, Tagami K, Mori M, Taniyama T, Nakajima N, Nakanishi E, Kako J, Miyashita M

  Annals of palliative medicine   12 ( 4 ) 717 - 728   2023年07月 [ 査読有り ]

  掲載種別: 研究論文（学術雑誌）

  　概要を見る

  BACKGROUND: Swallowing disorders including difficulty swallowing and food bolus obstruction, result in reduced dietary intake-a common occurrence that leads to cachexia in patients with advanced cancer. This study examined the effects of swallowing difficulty and food bolus obstruction on cachexia-related quality of life (QOL). METHODS: This study secondarily analyzed data from a self-reported questionnaire survey of adult patients with advanced cancer at 11 palliative care services. Difficulty swallowing and food bolus obstruction were measured using the 11-point Numeric Rating Scale (NRS), whereas dietary intake and cachexia-related QOL were assessed using the Ingesta-Verbal/Visual Analog Scale and the Functional Assessment of Anorexia/ Cachexia Therapy Anorexia/Cachexia Subscale. A multiple logistic regression model was employed to determine the factors associated with varying degrees of difficulty swallowing and food bolus obstruction. RESULTS: Of the invited 495 patients, 378 agreed to participate (response rate 76.4%). After excluding participants with missing data, the data of 332 participants were analyzed; 26.5% had difficulty swallowing (NRS ≥1) and 28.3% had food bolus obstruction (NRS ≥1). Multivariate analysis revealed a substantial association between difficulty swallowing and food bolus obstruction and a decrease in cachexia-related QOL, regardless of performance status and the existence of cachexia. The coefficients for difficulty swallowing and food bolus obstruction were -6.34 [95% confidence interval (CI): -9.55 to -3.14, P<0.001] and -5.88 (95% CI: -8.68 to -3.09, P<0.001), respectively. CONCLUSIONS: Cachexia-related QOL deteriorated as difficulty swallowing and food bolus obstruction worsened; thus, healthcare providers must diagnose and treat swallowing disorders in a timely manner to prevent progression of cachexia and improve cachexia-related QOL.

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• 緩和医療・終末期ケア

  長尾 和宏, 新城 拓也, 小澤 竹俊 ( 担当: 単著 )

  中山書店  2017年

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• 進行がん患者の点滴での栄養水分補給に関する信念と認識 多施設アンケート調査

  阿部 晃子, 天野 晃滋, 森田 達也, 三浦 智史, 森 直治, 多田羅 竜平, 結束 貴臣, 松田 能宣, 田上 恵太, 大谷 弘行, 森 雅紀, 谷山 朋彦, 中島 信久, 中西 絵里香, 角甲 純, 木内 大佑, 石木 寛人, 松岡 弘道, 里見 絵理子, 宮下 光令

  Palliative Care Research ( (NPO)日本緩和医療学会 )  17 ( Suppl. ) S.207 - S.207   2022年07月  [査読有り]

   

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• How to change artificial hydration and nutrition therapy toward the end stage of cancer, which has been provided in parallel with cancer treatment?

  Nobuhisa Nakajima

  46th ESPEN Congress on Clinical Nutrition and Metabolism  2024年09月  -  2024年09月   

• Building comprehensive palliative care education system in Japan based on the experience at COVID-19 pandemic

  Nobuhisa Nakajima

  13th World Research Congress of European Association for Palliative Care  2024年05月  -  2024年05月   

• Comprehensive education on palliative care for multidisciplinary medical professionals to “Disseminate”, “Enhance”, “Deepen” and “Collaborate” in a remote-islands prefecture in Japan.

  Nobuhisa Nakajima

  18th World Congress of European Association for Palliative Care  2023年06月  -  2023年06月   

• The evaluation of the methodological quality of clinical practice guidelines on palliative care for cancer patients in Japan

  Nobuhisa Nakajima

  18th World Congress of European Association for Palliative Care  2023年06月  -  2023年06月   

• The effectiveness of artificial hydration therapy for terminal cancer patients based on the Japanese clinical guideline

  Nobuhisa Nakajima

  11th World Research Congress Online European Association for Palliative Medicine  2020年10月  -  2020年10月   

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• 最優秀演題賞

  2020年08月   日本緩和医療学会、日本サイコオンコロジー学会、日本がんサポーティブケア学会   緩和ケアの均てん化に向けた沖縄の取り組み － 緩和ケアを「広める・高める・深める・繋げる」 包括的緩和ケアシステムの構築  

  受賞者: 中島信久

• 優秀演題賞

  2018年06月   日本緩和医療学会   緩和ケアにおいて多職種協働を進めていく上で歯科衛生士が抱える課題  

  受賞者: 中島信久

• Orange Circle Award 2010 特別賞

  1900年01月01日   Japan Partnar against Pain  

  受賞者: ■■■

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• がん診療病院において「がん治療と緩和ケアの統合」を実践するためのプログラムの開発

  基盤研究(C)

  課題番号: 22K07475

  研究期間: 2022年04月  -  2025年03月 

  代表者: 中島 信久, 藤 也寸志, 高橋 秀徳 

  直接経費: 3,200,000（円）  間接経費: 4,160,000（円）  金額合計: 960,000（円）

• がん診療病院において「がん治療と緩和ケアの統合」を実践するためのプログラムの開発

  基盤研究(C)

  課題番号: 22K07475

  研究期間: 2022年04月  -  2025年03月 

  代表者: 中島 信久, 藤 也寸志, 高橋 秀徳 

  直接経費: 3,200,000（円）  間接経費: 4,160,000（円）  金額合計: 960,000（円）

• がん患者の死前喘鳴に対する薬物療法の効果を推定するための全国レジストリ研究

  若手研究

  課題番号: 18K15396

  研究期間: 2018年04月  -  2021年03月 

  代表者: 中島 信久 

  直接経費: 3,200,000（円）  間接経費: 4,160,000（円）  金額合計: 960,000（円）

  　概要を見る

  死前喘鳴を呈した196名を解析対象とした。1) 全症例での検討では、抗コリン薬(ハイスコ、ブスコパン）使用の有無と喘鳴の強さの間に有意な差を認めなかった。2) T0（投与開始前）でBackの尺度が2以上の患者を対象とすると、12時間後ならびに20時間後に抗コリン薬の使用により喘鳴の強さは有意に軽減した。抗コリン薬の種類、投与方法（単回投与or持続投与）による差を認めなかった。 死前喘鳴に対する抗コリン薬投与に関しては、喘鳴の強さをもとに判断することで有意な改善効果を得ることが可能となる。今後、介入研究をデザインし、投与薬剤、投与方法による死前喘鳴への治療効果の差異を明らかにすることが求められる。

• がん患者の死前喘鳴に対する薬物療法の効果を推定するための全国レジストリ研究

  若手研究

  課題番号: 18K15396

  研究期間: 2018年04月  -  2021年03月 

  代表者: 中島 信久 

  直接経費: 3,200,000（円）  間接経費: 4,160,000（円）  金額合計: 960,000（円）

  　概要を見る

  死前喘鳴を呈した196名を解析対象とした。1) 全症例での検討では、抗コリン薬(ハイスコ、ブスコパン）使用の有無と喘鳴の強さの間に有意な差を認めなかった。2) T0（投与開始前）でBackの尺度が2以上の患者を対象とすると、12時間後ならびに20時間後に抗コリン薬の使用により喘鳴の強さは有意に軽減した。抗コリン薬の種類、投与方法（単回投与or持続投与）による差を認めなかった。 死前喘鳴に対する抗コリン薬投与に関しては、喘鳴の強さをもとに判断することで有意な改善効果を得ることが可能となる。今後、介入研究をデザインし、投与薬剤、投与方法による死前喘鳴への治療効果の差異を明らかにすることが求められる。