Annual Report 2023
Department of Psycho-Oncology Service
Asao Ogawa, Masanori Enokido, Yusei Iwata, Daisuke Fujisawa
Introduction
The aim of the Department of Psycho-Oncology Service is to develop mind-centered interventions to restore, maintain, and improve the quality of life of patients and their families throughout cancer treatment, including the end-of-life period. Our service has focused on developing effective interventions for delirium, dementia, and depression in cancer patients as well as on determining the mechanism underlying the relationship between cancer and the mind through a combination of neuropsychiatric, psychosocial, and behavioral sciences.
In particular, increases in the number of individuals diagnosed with cancer each year, due in large part to the growth of the aging population, as well as improving survival rates have resulted in an ever-increasing number of elderly cancer patients with deteriorating cognitive functions. Therefore, we conduct research on the development and validation of geriatric assessments such as Mini-Cog and comprehensive geriatric assessment (CGA), etc., and the evaluation of the effectiveness of multidisciplinary interventions among hospitalized cancer patients with delirium or cognitive function disorders, including mild cognitive impairment.
The Team and What We Do
The Department of Psycho-Oncology Service is composed of three attending psychiatrists and three clinical psychologists. The clinical activity includes psychiatric consultation involving comprehensive assessment and addressing the psychiatric problems of cancer patients. Patients are either self-referred or referred by their oncologist in charge. The consultation data are shown in Tables 1 and 2. Psychiatric diagnosis is established based on the DSM-5 (Diagnostic and Statistical Manual of Mental Disorder, 5th edition) criteria. Consultation data also include individuals who are family members of cancer patients.
A conference with the Supportive Care Team is held every Wednesday, and a multicenter joint clinical teleconference involving six cancer center hospitals and three university hospitals is held every Thursday.
Table 1. Supportive care team consultation data (n=1,724; April 2023 to March 2024)
Table 2. Psycho-oncology outpatient consultation data (n=715; April 2022 to March 2023)
Research Activities
1. A multicenter, cluster randomized controlled study comparing usual care and multidisciplinary interventions such as DELirium Team Approach-program (DELTA program) to prevent the development and severity of delirium among hospitalized cancer patients (Research and Development grants for cancer at the Japan Agency for Medical Research and Development)
Delirium, defined as an acute disorder of attention and global cognitive function, is a common, serious, and potentially preventable source of morbidity and mortality in hospitalized elderly individuals. Primary prevention, i.e., preventing delirium before it develops, is the most effective strategy for reducing delirium. We have reported the effectiveness of multidisciplinary intervention to prevent the development and reduce the severity of delirium among hospitalized patients, designed through a multicenter, cluster randomized controlled study.
2. Development of a dementia care support system utilizing artificial intelligence that proposes prevention and early detection of BPSD and appropriate care (Health Labour Sciences Research Grant)
With the growing number of elderly people, the prevalence of dementia with physical and mental conditions in acute care hospitals has increased. The purpose of this study is to disseminate appropriate dementia care in acute care hospitals in Japan through the development of a support system that utilizes artificial intelligence for physical care and dementia care for people with dementia.
We have reported the educational effects of dementia care for acute care hospital nurses and plan to evaluate the clinical effects.
3. Multicenter, double-blind, placebo-controlled, randomized controlled study on the efficacy and safety of ramelteon in preventing postoperative delirium in delirium high-risk cancer patients (Research and Development grants for cancer at the Japan Agency for Medical Research and Development)
Delirium is common in the elderly and is associated with worsening surgical outcomes, decreased quality of life, and mortality; however, no standard pharmacological preventive measures have been established. We have initiated a multi-center, double-blind, placebo-controlled trial to verify the delirium preventive effect and safety of the melatonin agonist ramelteon in elderly people before cancer surgery.
List of papers published in 2023
Journal
1. Hirayama T, Ogawa Y, Ogawa A, Igarashi E, Soejima S, Hata K, Utsumi Y, Mashiko Y, Ogata K, Kayano A, Yanai Y, Suzuki SI. Behavioral activation for depression in patients with advanced cancer: study protocol for a multicenter randomized controlled trial. BMC cancer, 23:427, 2023
2. Uchida M, Furukawa TA, Yamaguchi T, Imai F, Momino K, Katsuki F, Sakurai N, Miyaji T, Horikoshi M, Iwata H, Zenda S, Iwatani T, Ogawa A, Inoue A, Abe M, Toyama T, Uchitomi Y, Matsuoka H, Noma H, Akechi T. Optimization of smartphone psychotherapy for depression and anxiety among patients with cancer using the multiphase optimization strategy (MOST) framework and decentralized clinical trial system (SMartphone Intervention to LEssen depression/Anxiety and GAIN resilience: SMILE AGAIN project): a protocol for a randomized controlled trial. Trials, 24:344, 2023
3. Okuyama A, Kosaka H, Kaibori M, Higashi T, Ogawa A. Activities of daily living after surgery among older patients with gastrointestinal and hepatobiliary-pancreatic cancers: a retrospective observational study using nationwide health services utilisation data from Japan. BMJ open, 13:e070415, 2023
4. Abe A, Fujisawa D, Miyajima K, Takeuchi E, Takeuchi M, Mimura M, Imai K, Uemura K, Watanabe H, Matsuo N, Matsuda Y, Maeda I, Ogawa A, Yoshiuchi K, Iwase S. Influence of dosing pattern of antipsychotics on treatment outcome of delirium in patients with advanced cancer . Japanese journal of clinical oncology, 53:321-326 , 2023
5. Kim Y, Ting A, Carver CS, Bahcivan O, Bergerot CD, Csaba D, Estape T, Fujisawa D, Goswami SS, Tak Lam WW, Parvu A, Shim EJ, Serpentini S, Takeuchi E, Wang A. International collaboration for assessing unmet needs of cancer survivors and family caregivers: Lens of healthcare professionals . Psycho-oncology, 32:77-85 , 2023
Book
1. Fujisawa D, Akechi T, Uchitomi Y. Depressive Disorders . In: Kissane DW, Watson M, Breitbart W (ed), Psycho-Oncology in Palliative and End of Life Care, New York, Oxford University Press, pp 70-93 , 2023