Background：A palliative care education program based on the Cancer Control Act, namely the Palliative care Emphasis Program on symptom management and Assessment for Continuous medical Education（PEACE）, has been run in Japan since 2008. Purpose：The aim of this study was to evaluate the usefulness of PEACE for clinicalpractice. Method：Focus group interviews were conducted with 12 physicians who attended the program and were chosen by theoretical sampling. Two investigators independently performed thematic content analysis. Results：Qualitative analysis identified five main categories of usefulness of the program：（1）acquiring knowledge of palliative care；（2）acquiring skills to provide palliative care；（3）mastering an attitude of focusing on suffering；（4）acquiring knowledge about home palliative care；and（5）standardizing knowledge of basic palliative care in the community. Three main categories for program improvement were identified, namely the content and structure of the program, as well as the method of running the program. Conclusion：PEACE may be useful in providing systematic education in basic palliative care through the acquisition of basic knowledge and skills, discussion of cases with colleagues, observing good communication by other physicians, and networking in the community.

The effectiveness of the Kampo medicine shakuyakukanzoto extract for patients with muscle cramp is well known, but recently side effects related to pseudoaldosteronism have also been reported. To avoid this issue, Kampo medicines without Glycyrrhizae Radix are needed for treatment of muscle cramp. We investigated the therapeutic effect of shimotsuto extract, which has traditionally been used to treat anemia, in 26 patients (mean age : 70.7 ± 12.1 years) with muscle cramp. Improvement of the symptom was noted in 18 patients (69%), with no change in 8 patients (31%). The abdominal muscle tension of the former patients was significantly lower than the latter. Here, the cases of four representative patients in whom muscle cramp was improved by shimotsuto are described. The response rate to shimotsuto was similar to that of shakuyakukanzoto. Our results suggest that shimotsuto extract is a suitable alternative to shakuyakukanzoto for treatment of muscle cramp in older non-robust type patients not in need of emergency care.

Introduction: Number of palliative care team increase every year, but the quality of team might differ from each other. We developed “Self-Check Program for Palliative Care Team” to assess and improve the quality of palliative care team. We report the result of the multi-center study to assess the feasibility of this program. Methods: We underwent the “Self-Check Program” as a trial at seven hospitals in Japan in February 2016. We took a questionnaire survey to team leaders and participants to assess the feasibility of this program. Results: Fifty-two medical staffs in six hospitals accomplished this program. Time scheduling and the integration of opinions from each team members were the difficulties came up from questionnaire survey. All team leaders and 87.8% of the participants answered that this program was effective to extract and improve the problem of the team. Also 83.3% of the team leaders were satisfied with the process of planning. Conclusion: Despite some difficulties, majority of the participants considering useful, this program is considered feasible.

Objective: This study aimed to investigate the feasibility of a patient registry system for assessing PCT (palliative care team) by PRO (Patient-reported outcome) in Japan. Methods: We operated a patient registry system with electronic data collection at eight hospitals in 2021 in Japan. We consecutively included newly referred patients for a month and followed up with them for a month. IPOS or ESAS obtained as PRO at the start of the intervention, three days later, and every week after. The primary endpoint was the response rate to the symptom rating scale by patients and providers. Results: 318 patients were enrolled. The patient response rate was 59.1% at intervention and 37.0% after intervention, and the medical provider response rate was 98.4% at intervention and 70.3% after intervention. Interviews with PCT members indicated that participants required support to input PRO responses required support and paper questionnaire was better and that managing the survey date and overall management was burdensome. Discussion: Although only about half of the patients were able to respond to the PRO, this was the same level as in previous studies. The system and its operation method have many problems. We found that improvements such as reducing items and making the patient interviews paper-based are necessary to expand the system nationwide.