A region-based palliative care intervention trial using the mixed-method approach: Japan OPTIM study

Tatsuya Morita, Mitsunori Miyashita, Akemi Yamagishi, Nobuya Akizuki, Yoshiyuki Kizawa, Yutaka Shirahige, Miki Akiyama, Kei Hirai, Motohiro Matoba, Masako Yamada, Taketoshi Matsumoto, Takuhiro Yamaguchi, Kenji Eguchi

Disseminating palliative care is a critical task throughout the world. Several outcome studies explored the effects of regional palliative care programs on a variety of end-points, and some qualitative studies investigated the process of developing community palliative care networks. These studies provide important insights into the potential benefits of regional palliative care programs, but the clinical implications are still limited, because: 1) many interventions included fundamental changes in the structure of the health care system, and, thus, the results would not be applicable for many regions where structural changes are difficult or unfeasible; 2) patient-oriented outcomes were not measured or explored only in a small number of populations, and interpretation of the results from a patient's view is difficult; and 3) no studies adopted a mixed-method approach using both quantitative and qualitative methodologies to interpret the complex phenomenon from multidimensional perspectives.