Nurse-physician collaboration in pain management for terminally ill cancer patients treated at home in Japan.

Collaboration between nurses and physicians is essential for successful pain management, especially in home care settings. This study describes how physicians collaborate with nurses for the pain management of terminally ill cancer patients treated at home in Japan, and evaluates the use of standing orders in pain management. Self-administered questionnaires were sent to all 565 institutions listed in a nationwide database of home care service providers for terminally ill cancer patients; 177 responding institutions were analyzed. In general, institutions caring for fewer patients per year were less likely to make specific efforts to collaborate with nurses and less likely to use standing orders in pain management. Given that many institutions provide home palliative care services on a small scale, a standard protocol for care should be developed and applied across all institutions to ensure the availability of quality home palliative care throughout the country.