Neuropsychopharmacology reports · 2026
Eight-Year Progression of Clinical Practice Implementation Following Guideline Training in the EGUIDE Project.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Ide Kenta, Yamamuro Kazuhiko, Yamada Hisashi, Hasegawa Naomi, Arai Yusuke, Muraoka Hiroyuki, Horinouchi Toru, Kawamata Yasushi, Ochi Shinichiro, Tsuboi Takashi, Matsumoto Junya, Hashimoto Naoki, Ohi Kazutaka, Shusuke Numata, Hori Hikaru, Inada Ken, Watanabe Koichiro, Yasui-Furukori Norio, Hashimoto Ryota
Аннотация
AIM: Clinical practice guidelines have improved the quality and standardization of psychiatric care; however, their long-term implementation in real-world settings remains limited. The Effectiveness of the Guidelines for Dissemination and Education (EGUIDE) project was established to promote sustained evidence-based practice through a multilayered educational program for psychiatrists in Japan.
METHODS: This multicenter observational study longitudinally tracked psychiatrists' self-rated clinical behavior (CB) scores related to guideline adherence for up to 8 years after initial EGUIDE participation. CB was assessed using a validated questionnaire covering general guideline use (CB-G), schizophrenia (CB-S), and major depressive disorder (CB-D), with a comprehensive index (CB-C) representing the mean of all domains. Data were analyzed using the Kruskal-Wallis test, the Mann-Whitney U test, and the Bonferroni correction (two-tailed p < 0.05).
RESULTS: A total of 1562 psychiatrists (mean age, 32.7 ± 7.1 years) were included. All CB indices (CB-C, CB-G, CB-S, and CB-D) significantly improved post training compared with the baseline (H = 831.2-984.0; all p < 10-72), with small-to-moderate effect sizes (r = 0.09-0.29). These improvements were maintained throughout the 8-year follow-up, with no significant decline, and several domains showed small but continued increases between 3 and 7 years post training.
CONCLUSION: The EGUIDE program achieved long-term, sustained improvements in psychiatrists' guideline-adherent clinical behaviors through an integrated system combining education, supervision, feedback, and follow-up. This autonomous, cyclical framework represents a high-impact model for continuous quality improvement and may be adaptable to other medical specialties.
METHODS: This multicenter observational study longitudinally tracked psychiatrists' self-rated clinical behavior (CB) scores related to guideline adherence for up to 8 years after initial EGUIDE participation. CB was assessed using a validated questionnaire covering general guideline use (CB-G), schizophrenia (CB-S), and major depressive disorder (CB-D), with a comprehensive index (CB-C) representing the mean of all domains. Data were analyzed using the Kruskal-Wallis test, the Mann-Whitney U test, and the Bonferroni correction (two-tailed p < 0.05).
RESULTS: A total of 1562 psychiatrists (mean age, 32.7 ± 7.1 years) were included. All CB indices (CB-C, CB-G, CB-S, and CB-D) significantly improved post training compared with the baseline (H = 831.2-984.0; all p < 10-72), with small-to-moderate effect sizes (r = 0.09-0.29). These improvements were maintained throughout the 8-year follow-up, with no significant decline, and several domains showed small but continued increases between 3 and 7 years post training.
CONCLUSION: The EGUIDE program achieved long-term, sustained improvements in psychiatrists' guideline-adherent clinical behaviors through an integrated system combining education, supervision, feedback, and follow-up. This autonomous, cyclical framework represents a high-impact model for continuous quality improvement and may be adaptable to other medical specialties.