Relationships Between Adherence to Guideline Recommendations for Pharmacological Therapy Among Clinicians and Psychotic Symptoms in Patients With Schizophrenia

Kodaka, Fumitoshi; Ohi, Kazutaka; Yasuda, Yuka; Fujimoto, Michiko; Yamamori, Hidenaga; Hasegawa, Naomi; Ito, Seiichiro; Fukumoto, Kentaro; Matsumoto, Junya; Miura, Kenichiro; Yasui‐Furukori, Norio; Hashimoto, Ryota

doi:10.1093/ijnp/pyad037

Cited by 4 publications

(1 citation statement)

References 36 publications

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“…Otsuka Pharmaceutical is noted for one of the major manufacturers of atypical antipsychotic medications such as aripiprazole (brand name: Abilify) and brexpiprazole (brand name: Rexulti) which are the most widely prescribed atypical antipsychotic drugs in Japan [43]. Despite these nancial ties between the CPG authors and the pharmaceutical companies, the Japanese Society of Mood Disorders actively endorses adherence to these CPGs [44,45]. Considering that the CPGs for bipolar disorder and major depressive disorder include pharmacotherapy recommendations involving drugs from these companies, it is imperative to address the close nancial relationships between CPG authors and the pharmaceutical industry.…”

Section: Discussionmentioning

confidence: 99%

Financial conflicts of interest and disclosure in clinical practice guidelines for bipolar disorder and major depressive disorder in Japan

Murayama,

Kugo,

Senoo

2023

Preprint

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Clinical practice guidelines (CPGs) are essential for standardizing patient care based on evidence-based medicine. However, the presence of financial conflicts of interest (COIs) among CPG authors can undermine their credibility. This cross-sectional analysis of disclosed payments from pharmaceutical companies assesses the prevalence and magnitude of personal payments for lecturing, consulting, and writing to CPGs for bipolar disorder and major depressive disorder in Japan between 2016 and 2020. This study found that 93.5% of authors received payments over a five-year period, with total payments exceeding $4 million. The median payment per author was $49,422 (interquartile range: $7,792 – $111,567), with a notable concentration of payments among a small number of authors, including the CPG chairperson. Despite these extensive financial relationships, only a fraction of authors disclosed their COIs in the CPGs. These large amounts of personal payments were made by pharmaceutical companies manufacturing new antidepressants and sleeping aids listed in the CPGs. The findings highlight deviations from international COI management standards and suggest a need for more stringent COI policies for psychiatry CPGs in Japan.

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Section: Discussionmentioning

confidence: 99%

Financial conflicts of interest and disclosure in clinical practice guidelines for bipolar disorder and major depressive disorder in Japan

Murayama,

Kugo,

Senoo

2023

Preprint

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Better adherence to guidelines among psychiatrists providing pharmacological therapy is associated with longer work hours in patients with schizophrenia

Ito,

Ohi,

Yasuda

et al. 2023

Schizophr

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Schizophrenia is a psychiatric disorder that is associated with various social dysfunctions, including shorter work hours. To measure the degree to which psychiatrists adhere to guidelines for pharmacological therapy of schizophrenia, we recently developed the individual fitness score (IFS) for adherence among psychiatrists in each patient. However, it remains unclear whether better adherence among psychiatrists is associated with higher patients’ social functional outcomes, such as work hours. In this study, we examined the relationship between adherence to guidelines among psychiatrists and work hours in patients with schizophrenia. To evaluate the association between adherence to guidelines for pharmacological therapy among psychiatrists for treating schizophrenia and work hours, we used the IFS and social activity assessment, respectively, in 286 patients with schizophrenia. The correlation between IFS values and work hours was investigated in the patients. The adherence among psychiatrists to guidelines was significantly and positively correlated with work hours in patients with schizophrenia (rho = 0.18, p = 2.15 × 10−3). When we divided the patients into treatment-resistant schizophrenia (TRS) and nontreatment-resistant schizophrenia (non-TRS) groups, most patients with TRS (n = 40) had shorter work hours (0–15 h/week). Even after excluding patients with TRS, the positive correlation between adherence to guidelines among psychiatrists and work hours in patients with non-TRS (n = 246) was still significant (rho = 0.19, p = 3.32 × 10−3). We found that work hours were longer in patients who received the guideline-recommended pharmacotherapy. Our findings suggest that widespread education and training for psychiatrists may be necessary to improve functional outcomes in patients with schizophrenia.

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Cross-sectional analysis of pharmaceutical industry payments to authors of clinical practice guidelines for bipolar disorder and major depressive disorder in Japan

Murayama,

Kugo,

Senoo

2024

BMJ Open

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ObjectiveClinical practice guidelines (CPGs) are essential for standardising patient care based on evidence-based medicine. However, the presence of financial conflicts of interest (COIs) among CPG authors can undermine their credibility. This study aimed to examine the extent and size of COIs among authors of psychiatry CPGs in Japan.MethodsThis cross-sectional analysis of disclosed payments from pharmaceutical companies assesses the prevalence and magnitude of personal payments for lecturing, consulting and writing to CPGs for bipolar disorder and major depressive disorder in Japan between 2016 and 2020.ResultsThis study found that 93.3% of authors received payments over a 5-year period, with total payments exceeding US$4 million. The median payment per author was US$51 403 (IQR: US$9982–US$111 567), with a notable concentration of payments among a small number of authors, including the CPG chairperson. Despite these extensive financial relationships, only a fraction of authors disclosed their COIs in the CPGs. These large amounts of personal payments were made by pharmaceutical companies manufacturing new antidepressants and sleeping aids listed in the CPGs.ConclusionsThis study found that more than 93% of authors of CPGs for major depressive disorder and bipolar disorder in Japan received considerable amounts of personal payments from the pharmaceutical industry. The findings highlight deviations from international COI management standards and suggest a need for more stringent COI policies for psychiatry CPGs in Japan.

show abstract

Relationships Between Adherence to Guideline Recommendations for Pharmacological Therapy Among Clinicians and Psychotic Symptoms in Patients With Schizophrenia

Cited by 4 publications

References 36 publications

Financial conflicts of interest and disclosure in clinical practice guidelines for bipolar disorder and major depressive disorder in Japan

Financial conflicts of interest and disclosure in clinical practice guidelines for bipolar disorder and major depressive disorder in Japan

Better adherence to guidelines among psychiatrists providing pharmacological therapy is associated with longer work hours in patients with schizophrenia

Cross-sectional analysis of pharmaceutical industry payments to authors of clinical practice guidelines for bipolar disorder and major depressive disorder in Japan

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