Evidence map›Paper›PMID 41147405›Full record

Observational studyNeuropsychopharmacology reports2025

Long-Term Impact of EGUIDE Training on Facility-Wide Guideline Adherence Rate in Schizophrenia and Major Depressive Disorder: A Multicenter Study.

Naomi Hasegawa, Hiroyuki Muraoka, Yusuke Arai, Toru Horinouchi, Kazuhiro Yamamuro, Naoki Hashimoto, Shinichiro Ochi, Takashi Tsuboi, Yasushi Kawamata, Toshinori Nakamura and 11 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Neuropsychopharmacology reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Nationwide expansion of the EGUIDE project in Japan: A nine-year overview.PCN reports : psychiatry and clinical neurosciences · 2026
    Article
  2. Observational
  3. Observational
  4. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Naomi HasegawaDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Hiroyuki MuraokaDepartment of Psychiatry, Kitasato University, School of Medicine, Sagamihara, Kanagawa, Japan.
Yusuke AraiDepartment of Community Mental Health, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.ORCID https://orcid.org/0000-0002-3155-6971
Toru HorinouchiDepartment of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
Kazuhiro YamamuroCenter for Health Control, Nara Medical University, Kashihara, Nara, Japan.
Naoki HashimotoDepartment of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
Shinichiro OchiDepartment of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Takashi TsuboiDepartment of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan.
Yasushi KawamataDepartment of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan.
Toshinori NakamuraDepartment of Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
Yuka YasudaDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID https://orcid.org/0000-0002-2746-1590
Junya MatsumotoDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Satsuki ItoDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID https://orcid.org/0000-0003-4720-3166
Toshiaki OnitsukaNational Hospital Organization Sakakibara National Hospital, Tsu, Mie, Japan.ORCID https://orcid.org/0000-0001-6583-6405
Kazutaka OhiDepartment of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan.ORCID https://orcid.org/0000-0001-9577-9640
Shusuke NumataDepartment of Psychiatry, Graduate School of Biomedical Science, Tokushima University, Tokushima, Japan.
Hikaru HoriDepartment of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.ORCID https://orcid.org/0000-0001-8179-3054
Ken InadaDepartment of Psychiatry, Kitasato University, School of Medicine, Sagamihara, Kanagawa, Japan.
Koichiro WatanabeDepartment of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan.
Norio Yasui-FurukoriDepartment of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan.
Ryota HashimotoDepartment of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.

Funding

Health and Labor Sciences Research 19GC1012Health and Labor Sciences Research H29-Seishin-Ippan-001Japan Agency for Medical Research and Development JP16dk0307060Japan Agency for Medical Research and Development JP19dk0307083Japan Agency for Medical Research and Development JP22dk0307112Japan Society for the Promotion of Science JP21K17261Japan Society for the Promotion of Science JP23K16273The Japanese Society of Clinical NeuropsychopharmacologyThe Japanese Society of Mood DisordersThe Japanese Society of NeuropsychopharmacologyThe Japanese Society of Psychiatry and Neurology
6 · The paper itself

Abstract

objectiveThe Effectiveness Research on the Dissemination and Education of Psychiatric Clinical Practice Guidelines (EGUIDE Project) was launched in Japan to promote guideline-adherent treatment for schizophrenia and major depressive disorder (MDD) through educational outreach programs. Although short-term effects on participating physicians have been reported, the long-term and facility-wide effects remain unclear. This study evaluated whether guideline-compliant treatment behaviors improved across institutions over time, indicating potential diffusion or spillover effects.

methodsWe conducted a prospective observational study involving 298 psychiatric facilities between 2016 and 2023. Discharge prescriptions and treatment data were collected for 19 623 patients with schizophrenia and 9805 patients with MDD. Adherence to the guidelines was assessed using 11 schizophrenia quality indicators (QI-S) and seven MDD quality indicators (QI-D). We performed logistic regression analyses, adjusting for age, sex, and facility type, with Bonferroni correction for multiple comparisons.

resultsFor schizophrenia, significant year-on-year improvements were observed in seven of the 11 QI-S, including assessment of treatment-resistant schizophrenia (TRS) diagnosis (from 42.2% to 62.5%), use of modified electroconvulsive therapy (mECT; from 6.1% to 11.8%), and nonprescription of anticholinergics (from 70.7% to 81.7%). For MDD, three of the seven QI-D showed improvement, including assessment of severity diagnosis (from 51.2% to 77.0%) and use of mECT (from 12.8% to 26.6%). Notably, the implementation of cognitive behavioral therapy (CBT) decreased. These findings suggest long-term behavioral changes across all facilities, extending even to nonparticipating clinicians.

conclusionThe presence of EGUIDE-trained psychiatrists was associated with sustained improvements in guideline-compliant treatments at the institutional level. These results imply not only individual educational benefits but also a diffusion of practice culture-that is, a spillover effect-leading to enhanced quality of psychiatric care. Continued educational efforts are essential to improving treatment practices at scale.

trial registrationThe protocol for the EGUIDE Project is registered with the University Hospital Medical Information Network Registry (UMIN000022645).

Indexed as

Guideline AdherenceMajor Depressive DisorderSchizophreniaAdultFemaleHospitals, PsychiatricHumansJapanMaleMiddle AgedPractice Guidelines as TopicProspective Studiesevidence practice gapguidelinemajor depressive disorderquality indicatorsschizophrenia

Identifiers

PMID41147405
PMCPMC12560011

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.