Effect of education regarding treatment guidelines for schizophrenia and depression on the treatment behavior of psychiatrists: A multicenter study

Abstract

AimThis study aims to examine the real‐world effectiveness of education regarding clinical guidelines for psychiatric disorders using ‘the Effectiveness of guidelines for dissemination and education in psychiatric treatment (EGUIDE)’ project.MethodsThe EGUIDE project is a nationwide prospective implementation study of two clinical practice guidelines, i.e., the Guideline for Pharmacological Therapy of Schizophrenia and the Treatment Guidelines for Major Depressive Disorders, in Japan. Between 2016 and 2019, 782 psychiatrists belonging to 176 hospitals with psychiatric wards participated in the project and attended lectures on clinical practice guidelines. The proportions of guideline‐recommended treatments in 7405 patients with schizophrenia and 3794 patients with major depressive disorder at participating hospitals were compared between patients under the care of psychiatrists participating in the project and those not participating in the project. Clinical and prescribing data on the patients discharged from April to September each year from participating hospitals of the project were also analyzed.ResultsThe proportions of three quality indicators (antipsychotic monotherapy regardless of whether other psychotropics medication, antipsychotic monotherapy without other psychotropics and no prescription of anxiolytics or hypnotics) for schizophrenia were higher among participating psychiatrists than among nonparticipating psychiatrists. As similar results were obtained in major depressive disorder, the effectiveness of the project for the dissemination of guideline‐recommended treatment has been replicated.ConclusionThis strategy of providing education regarding the clinical guidelines for psychiatric disorders was effective in improving the treatment‐related behavior of psychiatrists. The use of this education‐based strategy might contribute to resolving the mental health treatment gap.

The effect of education regarding treatment guidelines for schizophrenia and major depressive disorders on psychiatrists' hypnotic medication prescribing behavior: a multicenter study

“…First, postgraduate education for psychiatrists working at the front line of treatment on basic medical treatment methods and treatment techniques for psychiatric patients with sleep problems is considered an important option to promote behavioral change among psychiatrists. It has been previously reported that participation in the EGUIDE project increased psychiatrists' expertise and changed their practice behavior [ 7 , 9 , 10 ]. The second method is to provide more specialized sleep treatment.…”

“…These patient data were divided into two groups: patients treated by psychiatrists participating in the EGUIDE project (EGUIDE ( +)) and patients treated by psychiatrists not participating in the EGUIDE project (EGUIDE (-)), as described in a previous study. If both EGUIDE ( +) and EGUIDE (-) patients were assigned to the same patient, they were assigned to the EGUIDE ( +) group [ 10 ].…”

“…Treatment data were collected from patients with schizophrenia and patients with major depressive disorder who were discharged from the participating facilities [ 7 , 10 , 16 ]. Patients who were hospitalized for less than 3 days or hospitalized for laboratory purposes only were excluded.…”

“…Previous studies have shown that participation in the EGUIDE project improves participants' knowledge of and attitudes toward adhering to guidelines [ 7 , 8 ] and that these effects are maintained for at least two years [ 9 ]. Moreover, participation in the EGUIDE project has been shown to be effective in improving psychiatrists' treatment-related behaviors, including antipsychotic monotherapy for schizophrenia patients and antidepressant monotherapy for major depressive disorder patients [ 10 ].…”