Clinical Benefit of Cancer Philosophy Clinic for Cancer Patients Using EQ-5D-5L Scores.

Objective: This study aims to understand the role of Cancer Philosophy Clinic activities among participants and whether participation is correlated to increase in QOL. Materials and Methods: Among the 150 Cancer Philosophy Clinics, questionnaire surveys were distributed at 28 locations that consented to participating in the study. The data was analyzed based on the respondent's situation and health related Quality of Life (QOL) prior to and after participating in Cancer Philosophy Clinic using the EQ-5D-5L questionnaire (Japanese version) regarding health related QOL prior to and after participating in Cancer Philosophy Clinic. Results: There were more female participants than male participants; 224 and 76 respectively. 46.5%, or approximately half of all participants in the Cancer Philosophy Clinic were "cancer patients," followed by 17.2% who were "family members of cancer patients," 16.6% who were "not suffering from any diseases," 11.4% who were "suffering from diseases other than cancer" and 3.2% who were classified as "other," who were bereaved family members. 51.7% were "currently receiving treatment, "32.1% were "receiving follow-up medical care, "and 15.3% were "survivors." There was 1 participant who commented, "refusing treatment." Based on an evaluation of QOL using EQ-5D-5L of 184 participants who were participating in the Cancer Philosophy Clinic, an increase in overall average index value from 0.827 to 0.867 was observed after participation compared to prior participation. In particular, there was a significant improvement in "pain/discomfort," "anxiety/depression. Conclusions: Cancer Philosophy clinic has been found important role in encouraging existing shift.

Introduction of a Multidisciplinary Preoperative Clinic at Juntendo University Hospital - A Retrospective Observational Study Focusing on Effects of Preoperative Interventions on Clinical Outcomes.

Objectives: To investigate the effects of interventions provided by a multidisciplinary team consisting of anesthesiologists, dentists, pharmacists, and nurses at a Preoperative Clinic (POC) on postoperative outcomes. Methods: We retrospectively investigated patients who underwent preoperative evaluation at the POC at Juntendo University Hospital between May and July, 2019. Patients were divided into intervention and non-intervention groups according to whether they received intervention(s) at the POC or not. Postoperative outcomes were compared between the groups, before and after propensity score (PS) matching. Results: We investigated 909 patients who completed POC evaluation and underwent surgery. Patients in the intervention group (n = 455 [50.1%]) received at least one intervention delivered, in the order of higher delivery frequencies, by dentists, pharmacists, nurses, and anesthesiologists. Before PS matching, the intervention group was associated with older age, more frequent cardiovascular comorbidities, and higher ASA-PS grades than the non-intervention group, while neither frequencies nor severities of postoperative complications differed between the groups. These outcomes did not differ between 382 PS-matched pairs with comparable risk factors either. Conclusions: Before PS matching, postoperative outcomes did not differ between the groups, although the intervention group was associated with higher risks. These suggested that POC interventions could have improved postoperative outcomes in the higher-risk intervention group to the same level as in the non-intervention group. However, such potential beneficial effects of interventions could not be proven after PS matching. Further studies are required to elucidate effects of POC interventions on postoperative outcomes.

A Comparison Between Effects of Amenamevir and Famciclovir on Intensities of Acute Pain and the Incidence of Postherpetic Neuralgia in Adult Patients with Herpes Zoster.

Objective: Herpes zoster (HZ) is a common disease, whose most common complication is postherpetic neuralgia (PHN). We conducted this study to compare effects of amenamevir (AMNV) and famciclovir (FCV) on intensities of acute HZ pain and the incidence of PHN, which have not been compared yet. Methods: After approval by the Ethics Committee, we retrospectively investigated adult patients with HZ treated with AMNV or FCV at Juntendo University Hospital between October, 2018 and February, 2020. We compared, between 143 AMNV-treated and 131 FCV-treated patients, pain scores of acute HZ pain evaluated on an 11-point numerical rating scale (NRS) and the incidence of PHN with the Mann-Whitney U test and Pearson's chi-square test, respectively. The univariate logistic regression analysis was used to identify predictors of PHN. Results: Pain scores during the acute HZ period remained significantly lower in AMNV-treated patients than FCV-treated patients (p = 0.049, 0.011, and 0.016 for Day 3-4, Day 7, and Week 2-3, respectively), although the pain score at Day 0 before treatment didn't differ between them (p > 0.05). The incidence of PHN didn't differ between them (9.8% vs. 11.5%, p > 0.05). In the total cohort, the pain score at Week 2-3 was significantly associated with the development of PHN (r 2 = 0.180, p < 0.00001). Conclusions: Compared with FCV, AMNV was more effective in reducing acute HZ pain, possibly reflecting its unique mechanism of action. However, AMNV didn't reduce the incidence of PHN possibly due to the multifactorial etiology of PHN.