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A national registry study to estimate the effect of pharmacotherapy on death rattle in cancer patients

Research Project

Project/Area Number 18K15396
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 52010:General internal medicine-related
Research InstitutionUniversity of the Ryukyus

Principal Investigator

Nobuhisa Nakajima  琉球大学, 病院, 特命准教授 (70749770)

Project Period (FY) 2018-04-01 – 2021-03-31
Project Status Completed (Fiscal Year 2020)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2019: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Keywords死前喘鳴 / 緩和ケア / がん終末期 / 薬物療法 / 抗コリン薬 / レジストリ研究 / 終末期ケア / がん患者
Outline of Final Research Achievements

A total of 196 patients who presented with death rattle were included in the analysis. 1) In the study of all patients, there was no significant difference between the use of anticholinergic drugs (Scopolamine hydrobromide, Scopolamine butylbromide) and the intensity of wheezing. 2) The use of anticholinergic drugs significantly reduced the intensity of wheezing at 12 and 20 hours in patients with a Back scale of 2 or higher than that at T0 (before starting these drugs). There was no significant difference in the type of anticholinergic drug or method of administration (single or continuous).
In terms of anticholinergic medication for death rattle, it is possible to obtain significant improvement by making decisions based on the intensity of the wheezing. In the future, interventional studies should be designed to clarify the differences in the therapeutic effects of anticholinergic drugs and administration methods on death rattle.

Academic Significance and Societal Importance of the Research Achievements

今回の研究で得られた成果を、以下に示す①~③のような取り組みに繋げることが、本研究の学術的意義ならびに社会的意義である。
①研究代表者が委員長を務める日本緩和医療学会ガイドライン統括委員会における各種ガイドラインの作成・改訂に反映させる。②適切なデザインの介入研究を行うことにより治療効果を推定する方法論を確立させる。③レジストリ研究による治療効果の推定という点で、高齢者プライマリケアなど、比較試験を行いにくい関連研究領域への研究方法に応用する。

Report

(4 results)
  • 2020 Annual Research Report   Final Research Report ( PDF )
  • 2019 Research-status Report
  • 2018 Research-status Report
  • Research Products

    (22 results)

All 2021 2020 2019 2018

All Journal Article (9 results) (of which Peer Reviewed: 9 results,  Open Access: 4 results) Presentation (13 results) (of which Int'l Joint Research: 6 results,  Invited: 2 results)

  • [Journal Article] Differential Diagnosis of Cachexia and Refractory Cachexia and the Impact of Appropriate Nutritional Intervention for Cachexia on Survival in Terminal Cancer Patients2021

    • Author(s)
      Nakajima Nobuhisa
    • Journal Title

      Nutrients

      Volume: 13 Issue: 3 Pages: 915-915

    • DOI

      10.3390/nu13030915

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Low-Dose Trazodone for Delirium in Patients with Cancer Who Received Specialist Palliative Care: A Multicenter Prospective Study2021

    • Author(s)
      Maeda I, Inoue S, Uemura K, Tanimukai H, Hatano Y, Yokomichi N, Amano K, Tagami K, Yoshiuchi K, Ogawa A, Iwase S.
    • Journal Title

      J Palliat Med.

      Volume: in press Issue: 6 Pages: 914-918

    • DOI

      10.1089/jpm.2020.0610

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Challenges of Dental Hygienists in a Multidisciplinary Team Approach During Palliative Care for Patients With Advanced Cancer: A Nationwide Study2020

    • Author(s)
      Nakajima Nobuhisa
    • Journal Title

      American Journal of Hospice and Palliative Medicine?

      Volume: 38 Issue: 7 Pages: 794-799

    • DOI

      10.1177/1049909120960708

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed
  • [Journal Article] The Effectiveness of Artificial Hydration Therapy for Patients With Terminal Cancer Having Overhydration Symptoms Based on the Japanese Clinical Guidelines A Pilot Study2020

    • Author(s)
      Nakajima Nobuhisa
    • Journal Title

      American Journal of Hospice and Palliative Medicine?

      Volume: 37 Issue: 7 Pages: 521-526

    • DOI

      10.1177/1049909119895214

    • Related Report
      2020 Annual Research Report 2019 Research-status Report
    • Peer Reviewed
  • [Journal Article] 尊厳と安心のある社会に向けた緩和ケアと地域づくり2020

    • Author(s)
      中島信久
    • Journal Title

      医療と社会

      Volume: 30 Pages: 43-52

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Effectiveness of rapid titration with intravenous administration of oxycodone injection in advanced cancer patients with severe pain2019

    • Author(s)
      Nakajima Nobuhisa
    • Journal Title

      Japanese Journal of Clinical Oncology

      Volume: 49 Issue: 11 Pages: 1061-1064

    • DOI

      10.1093/jjco/hyz145

    • Related Report
      2019 Research-status Report
    • Peer Reviewed
  • [Journal Article] Clinical Guidelines for Management of Gastrointestinal Symptoms in Cancer Patients: The Japanese Society of Palliative Medicine Recommendations2019

    • Author(s)
      Hisanaga Takayuki、Shinjo Takuya、Imai Kengo、Katayama Kanji、Kaneishi Keisuke、Honma Hideyuki、Takagaki Nobumasa、Osaka Iwao、Matsuo Naoki、Kohara Hiroyuki、Yamaguchi Takashi、Nakajima Nobuhisa
    • Journal Title

      Journal of Palliative Medicine

      Volume: 未定 Issue: 8 Pages: 986-997

    • DOI

      10.1089/jpm.2018.0595

    • Related Report
      2018 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Treatment Recommendations for Urological Symptoms in Cancer Patients: Clinical Guidelines from the Japanese Society for Palliative Medicine2019

    • Author(s)
      Tsushima Tomoyasu、Miura Takafumi、Hachiya Takahiko、Nakamura Ichiro、Yamato Toyoko、Kishida Takeshi、Tanaka Yoshinori、Irie Shin、Meguro Norio、Kawahara Takashi、Nakajima Nobuhisa、on behalf of the Japanese Society for Palliative Medicine
    • Journal Title

      Journal of Palliative Medicine

      Volume: 22 Issue: 1 Pages: 54-61

    • DOI

      10.1089/jpm.2018.0116

    • Related Report
      2018 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Low Transthyretin Levels Predict Poor Prognosis in Cancer Patients in Palliative Care Settings2018

    • Author(s)
      Miura Tomofumi、Amano Koji、Shirado Akemi、Baba Mika、Ozawa Taketoshi、Nakajima Nobuhisa、Suga Akihiko、Matsumoto Yoshihisa、Shimizu Mie、Shimoyama Satofumi、Kuriyama Toshiyuki、Matsuda Yoshinobu、Iwashita Tomoyuki、Mori Ichiro、Kinoshita Hiroya
    • Journal Title

      Nutrition and Cancer

      Volume: 70 Issue: 8 Pages: 1283-1289

    • DOI

      10.1080/01635581.2018.1557213

    • Related Report
      2018 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] Impact of defferential diagnosis of cachexia and refractory cachexia and appropriate nutritional support for cachexia on survival in terminal cancer patients.2020

    • Author(s)
      Nakajima Nobuhisa
    • Organizer
      ESMO virtual congress 2020 (European Society of Medical Oncology)
    • Related Report
      2020 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Effectiveness of artificial hydration therapy for terminal cancer patients based on the Japanese clinical guideline.2020

    • Author(s)
      Nakajima Nobuhisa
    • Organizer
      11th World Research Congress of the European Association for Palliative Care
    • Related Report
      2020 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Why is the quality of Japanese clinical practice guidelines on palliative care higher? What should we do for further improvement of the quality of these guidelines?2020

    • Author(s)
      Nobuhisa Nakajima
    • Organizer
      11th World Research Congress of the European Association for Palliative Care
    • Related Report
      2020 Annual Research Report
    • Int'l Joint Research
  • [Presentation] がん悪液質に対する栄養治療-「悪液質」と「不可逆性悪液質」の鑑別と栄養治療の評価2020

    • Author(s)
      中島信久
    • Organizer
      第35回日本臨床栄養代謝学会学術集会
    • Related Report
      2020 Annual Research Report
  • [Presentation] がん終末期にだんだんと食べられなくなっていく中で、口腔環境を保つことが全人的苦痛の緩和に果たす役割2020

    • Author(s)
      中島信久
    • Organizer
      第35回日本臨床栄養代謝学会学術集会
    • Related Report
      2020 Annual Research Report
  • [Presentation] The usefulness of Integrated Palliative care Outcome Scale (IPOS)2019

    • Author(s)
      Nakajima Nobuhisa
    • Organizer
      16th World cingress of the European Association for palliative Care
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research
  • [Presentation] Problems that hygienists have on performing multidisciplinary approach on palliative care2019

    • Author(s)
      Nakajima Nobuhisa, IkegamiYumiko, Kawana Michiko, Funabara Madoka, Teramatsu Junko
    • Organizer
      16th World cingress of the European Association for palliative Care
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research
  • [Presentation] 緩和ケアにおける口腔ケア -だんだんと食べられなくなっていく中で口腔ケアにどのように取り組むか-2019

    • Author(s)
      中島信久
    • Organizer
      第16回日本口腔ケア学会学術大会(教育講演)
    • Related Report
      2019 Research-status Report
    • Invited
  • [Presentation] 「がん患者の治療抵抗性の苦痛と鎮静に関する基本的な考え方の手引き 2018年版」2019

    • Author(s)
      中島信久
    • Organizer
      第24回日本緩和医療学会学術大会(企画セッション)
    • Related Report
      2019 Research-status Report
  • [Presentation] The future of palliative care. Comprehensive education on palliative care to 'Spread', 'Heighten' and 'Deepen' in Okinawa2019

    • Author(s)
      Nakajima Nobuhisa
    • Organizer
      57th Japanese Society of Clinical Oncology(ワークショップ)
    • Related Report
      2019 Research-status Report
  • [Presentation] 緩和ケアと口腔ケア-だんだんと食べられなくなっていく中での口腔ケアの役割2019

    • Author(s)
      中島 信久
    • Organizer
      第16回日本口腔ケア協会学術大会
    • Related Report
      2018 Research-status Report
    • Invited
  • [Presentation] 終末期がん患者において不可逆性悪液質と飢餓をどのように見分け、どのように介入するか?2019

    • Author(s)
      中島 信久
    • Organizer
      第34回日本静脈経腸栄養学会学術大会(シンポジウム)
    • Related Report
      2018 Research-status Report
  • [Presentation] How to distinguish starvation from refractory cachexia in terminal cancer patients and how to perform nutritional support?2018

    • Author(s)
      Nobuhisa Nakajima
    • Organizer
      10th World rresearch congress of the european association for palliative care
    • Related Report
      2018 Research-status Report
    • Int'l Joint Research

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Published: 2018-04-23   Modified: 2022-01-27  

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