Skip to main content

Advertisement

Springer Nature Link
Log in

Consultations of patients with cancer to enhance shared decision-making in Japan: A retrospective observational study

  • Research
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Treatment decisions are often highly complex when the outcomes are uncertain. In Japan, the consultation fees incurred can be reimbursed when physicians and nurses work together with patients to provide shared decision-making (SDM) on treatment plans. However, the extent to which reimbursed consultations are used by clinicians is unclear. This study aimed to determine the extent to which so-called “reimbursed SDM consultations” are used in cancer treatment and to identify the characteristics of patients having these consultations using a nationwide database.

Methods

This retrospective study used health service utilization data linked to hospital-based cancer registries from 591 hospitals in Japan. Data for patients aged 18 years or above diagnosed with cancer in 2019 were analyzed. Multivariable logistic regression analysis was conducted to analyze the association between reimbursed SDM consultations and patient characteristics.

Results

Overall, 74,828 patients (12.2%) received reimbursed SDM consultations in 533 hospitals. The presence of breast cancer (odds ratio (OR) = 2.00), treatment types of radiotherapy (OR = 1.86) and pharmacotherapy (OR = 1.76), and distant metastasis (OR = 1.49) and the invasion of adjacent organs (regional) (OR = 1.47) were positively associated with reimbursed SDM consultations. Cervical (OR = 0.38) and renal cancers (OR = 0.49) were negatively associated with reimbursed SDM consultations.

Conclusion

This study is the first to determine the extent to which reimbursed SDM consultations are used and the characteristics of the patients receiving them. Further studies should investigate the factors influencing the use of reimbursed SDM consultations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Our data are permitted for use only in this study and are not publicly available. 

References

  1. Friedel AL, Siegel S, Kirstein CF, Gerigk M, Bingel U, Diehl A, Steidle O, Haupeltshofer S, Andermahr B, Chmielewski W, Kreitschmann-Andermahr I (2023) Measuring patient experience and patient satisfaction-how are we doing it and why does it matter? A comparison of European and US American approaches. Healthcare 11(6):797. https://doi.org/10.3390/healthcare11060797

    Article  PubMed  PubMed Central  Google Scholar 

  2. Glickman SW, Schulman KA (2013) The mis-measure of physician performance. Am J Manag Care 19(10):782–785

    PubMed  Google Scholar 

  3. Wagner EH, Aiello Bowles EJ, Greene SM, Tuzzio L, Wiese CJ, Kirlin B, Clauser SB (2010) The quality of cancer patient experience: perspectives of patients, family members, providers and experts. Qual Saf Health Care 19(6):484–489. https://doi.org/10.1136/qshc.2010.042374

    Article  PubMed  Google Scholar 

  4. Wagner EH, Ludman EJ, Aiello Bowles EJ, Penfold R, Reid RJ, Rutter CM, Chubak J, McCorkle R (2014) Nurse navigators in early cancer care: a randomized, controlled trial. J Clin Oncol 32(1):12–18. https://doi.org/10.1200/JCO.2013.51.7359

    Article  PubMed  Google Scholar 

  5. Kehl KL, Landrum MB, Arora NK, Ganz PA, van Ryn M, Mack JW, Keating NL (2015) Association of actual and preferred decision roles with patient-reported quality of care: shared decision making in cancer care. JAMA Oncol 1(1):50–58. https://doi.org/10.1001/jamaoncol.2014.112

    Article  PubMed  PubMed Central  Google Scholar 

  6. Okuyama A, Higashi T (2018) Patterns of cancer treatment in different age groups in Japan: an analysis of hospital-based cancer registry data, 2012–2015. Jpn J Clin Oncol 48(5):417–425. https://doi.org/10.1093/jjco/hyy032

    Article  PubMed  Google Scholar 

  7. International Agency for Research on Cancer (2023) Cancer today. https://gco.iarc.fr/today/home. Accessed 7 February 2024

  8. Billmeier SE, Ayanian JZ, He Y, Jaklitsch MT, Rogers SO (2013) Predictors of nursing home admission, severe functional impairment, or death one year after surgery for non-small cell lung cancer. Ann Surg 257(3):555–563. https://doi.org/10.1097/SLA.0b013e31828353af

    Article  PubMed  Google Scholar 

  9. National Cancer Center Institute of Cancer Control (2018) Patient experience survey. https://www.ncc.go.jp/jp/icc/health-serv/project/040/index.html. Accessed 7 February 2024

  10. Ministry of Health, Labour and Welfare (2023) Revision of medical reimbursement. https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000106602.html. Accessed 7 February 2024

  11. Sakai T, Watanabe M (2014) Current status and issues of cancer patient counseling at Takamatsu Red Cross Hospital. Bull Takamatsu Red Cross Hosp 2:27–30

    Google Scholar 

  12. Egashira S, Hashino Y, Kaguchi C, Kajisa N, Matsuda Y, Okamoto Y (2019) Collaboration of diagnostic test results by palliative care certified nurses and clinical laboratory technicians. Gan To Kagaku Ryoho 46(12):1867–1871

    PubMed  Google Scholar 

  13. Iwamoto M, Nakamura F, Higashi T (2016) Monitoring and evaluating the quality of cancer care in Japan using administrative claims data. Cancer Sci 107(1):68–75. https://doi.org/10.1111/cas.12837

    Article  CAS  PubMed  Google Scholar 

  14. Okuyama A, Tsukada Y, Higashi T (2021) Coverage of the hospital-based cancer registries and the designated cancer care hospitals in Japan. Jpn J Clin Oncol 51:992–998. https://doi.org/10.1093/jjco/hyab036

    Article  PubMed  Google Scholar 

  15. National Cancer Center (2023) Standard registration form for hospital-based cancer registries 2016. https://ganjoho.jp/med_pro/cancer_control/can_reg/hospital/regulation.html Accessed 9 February 2024

  16. Higashi T, Nakamura F, Shibata A, Emori Y, Nishimoto H (2014) The national database of hospital-based cancer registries: a nationwide infrastructure to support evidence-based cancer care and cancer control policy in Japan. Jpn J Clin Oncol 44:2–8. https://doi.org/10.1093/jjco/hyt013

    Article  PubMed  Google Scholar 

  17. National Cancer Center (2021) Cancer statistical report of hospital-based cancer registries 2021. https://ganjoho.jp/public/qa_links/report/hosp_c/pdf/2021_report_02.pdf. Accessed 7 February 2024

  18. National Cancer Center (2015) Cancer survival in hospital-based cancer registries 2015. https://hbcr-survival.ganjoho.jp/search. Accessed7 February 2024

  19. Sakamoto S, Otose H (2017) Support for cancer patients in outpatient cancer nursing and activities of specialized and certified nurses. Jpn J Nurs Sci 42:14–20

    Google Scholar 

  20. The Japanese Breast Cancer Society (2022) Clinical practice guidelines for breast cancer 2022. https://jbcs.xsrv.jp/guideline/2022/. Accessed 7 February 2024

  21. Veenstra CM, Hawley ST (2020) Incorporating patient preferences into cancer care decisions: Challenges and opportunities. Cancer 126:3393–3396. https://doi.org/10.1002/cncr.32959

    Article  PubMed  Google Scholar 

  22. The Japanese Breast Cancer Society (2023) Breast cancer treatment guidelines for patients. https://jbcs.xsrv.jp/guideline/p2023/. Accessed 7 February 2024

Download references

Acknowledgements

We thank the tumor registrars in the hospitals for registering the data that enabled our analysis. We would like to thank Editage for English language editing.

Funding

This work was supported by JSPS KAKENHI (Grant Number 22K10700). The funders had no role in the design, analysis, writing, or decision to submit this manuscript for publication.

Author information

Authors and Affiliations

  1. Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan

    Ayako Okuyama

  2. National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Ayako Okuyama & Takahiro Higashi

  3. The University of Tokyo Hospital in Japan, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Yukie Takemura

  4. Division of Nursing, Faculty of Healthcare, Tokyo Healthcare University, 4-1-17 Higashigotanda, Shinagawa-ku, Tokyo, 113-0033, Japan

    Minako Sasaki

  5. Department of Public Health and Health Policy, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Takahiro Higashi

Authors
  1. Ayako Okuyama
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Yukie Takemura
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Minako Sasaki
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Takahiro Higashi
    View author publications

    You can also search for this author inPubMed Google Scholar

Contributions

All the authors contributed to the study’s conception and design. Data collection was conducted by T.H. and A.O.. Data analysis was performed by A.O.. The first draft of the manuscript was written by A.O.. All the authors commented on the previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Ayako Okuyama.

Ethics declarations

Ethics approval

This study adhered to the Declaration of Helsinki and was approved by the Institutional Review Board of St. Luke’s International University (22-AC106) and the Committee of the National Cancer Center in Japan.

Consent

Owing to the retrospective nature of the data, the project outlines were made public to provide patients with the opportunity to decline participation according to the national ethics guidelines for medical research on human participants.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Okuyama, A., Takemura, Y., Sasaki, M. et al. Consultations of patients with cancer to enhance shared decision-making in Japan: A retrospective observational study. Support Care Cancer 33, 335 (2025). https://doi.org/10.1007/s00520-025-09408-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00520-025-09408-7

Keywords