ArticleInternational journal of clinical oncology2026
Cumulative multidisciplinary team messages and home death after palliative care unit discharge in advanced cancer: a prospective regional implementation cohort study.
Article in International journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAdvanced cancer patients leaving a palliative care unit (PCU) require coordinated hospital-community transition support, yet outcome-linked evidence from real-world post-PCU regional coordination infrastructure remains limited.
methodsThis prospective cohort study included consecutive advanced cancer patients registered on an ICT-supported communication platform in anticipation of PCU discharge in a Japanese regional care model between June 2018 and August 2022 (n = 169). The exposure was cumulative post-discharge multidisciplinary team messages, modeled as log2(1 + messages). The outcome was home death. Multivariable logistic regression adjusted for age, sex, major cancer category, and baseline palliative prognostic index.
resultsAmong 169 patients, 98 (58.0%) died at home. Median cumulative team messages were 19 (IQR, 9-31). Higher cumulative message volume was associated with home death (adjusted odds ratio, 1.48; 95% confidence interval, 1.13-1.93; p = 0.004). Sensitivity analyses were directionally consistent, although the estimate attenuated after excluding patients with 0 days of observed post-discharge home follow-up.
conclusionsWithin this regional post-PCU transition model, cumulative multidisciplinary team message volume was associated with home death. Message volume should be interpreted as an implementation-level marker of ICT-mediated communication-system use, infrastructure use, and communication opportunity, not as a causal intervention dose, a direct measure of coordination quality, or evidence that ICT itself improved outcomes. These findings may inform palliative oncology discharge planning and regional care-system design.
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