Observational studyNeuropsychopharmacology reports2025
Long-Term Impact of EGUIDE Training on Facility-Wide Guideline Adherence Rate in Schizophrenia and Major Depressive Disorder: A Multicenter Study.
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.
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The trial behind it
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Who cites it
4 citing papers in PubMed.
- Nationwide expansion of the EGUIDE project in Japan: A nine-year overview.PCN reports : psychiatry and clinical neurosciences · 2026Article
- Association Between Psychiatrists' Subjective Clinical Behavior Scores and Objective Quality Indicators Based on Discharge Prescriptions: A Nationwide Multicenter Study Based on the EGUIDE Project.Neuropsychopharmacology reports · 2026Observational
- Eight-Year Progression of Clinical Practice Implementation Following Guideline Training in the EGUIDE Project.Neuropsychopharmacology reports · 2026Observational
- Long-Term Impact of EGUIDE Training on Facility-Wide Guideline Adherence Rate in Schizophrenia and Major Depressive Disorder: A Multicenter Study.Neuropsychopharmacology reports · 2025Observational
Corrections and comments
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Authors and funding
21 authors.
Funding
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).
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