Unmet needs of patients with major depressive disorder - Findings from the 'Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE)' project: A nationwide dissemination, education, and evaluation study.
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SUBMITTER: Iida H
PROVIDER: S-EPMC7756454 | biostudies-literature | 2020 Dec
REPOSITORIES: biostudies-literature
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Unmet needs of patients with major depressive disorder - Findings from the 'Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE)' project: A nationwide dissemination, education, and evaluation study.
Iida Hitoshi H Iga Junichi J Hasegawa Naomi N Yasuda Yuka Y Yamamoto Tomoya T Miura Kenichiro K Matsumoto Junya J Murata Atsunobu A Ogasawara Kazuyoshi K Yamada Hisashi H Hori Hikaru H Ichihashi Kayo K Hashimoto Naoki N Ohi Kazutaka K Yasui-Furukori Norio N Tsuboi Takashi T Nakamura Toshinori T Usami Masahide M Furihata Ryuji R Takaesu Yoshikazu Y Iwamoto Kunihiro K Sugiyama Nobuhiro N Kishimoto Taishiro T Tsujino Naohisa N Yamada Hiroki H Hishimoto Akitoyo A Nemoto Kiyotaka K Atake Kiyokazu K Muraoka Hiroyuki H Katsumoto Eiichi E Oishi Satoru S Inagaki Takahiko T Ito Fumiaki F Imamura Yayoi Y Kido Mikio M Nagasawa Tatsuya T Numata Shusuke S Ochi Shinichiro S Iwata Masaaki M Yamamori Hidenaga H Fujita Junichi J Onitsuka Toshiaki T Yamamura Satoshi S Makinodan Manabu M Fujimoto Michiko M Takayanagi Yoichiro Y Takezawa Kenji K Komatsu Hiroshi H Fukumoto Kentaro K Tamai Shinichiro S Yamagata Hirotaka H Kubota Chika C Horai Tadasu T Inada Ken K Watanabe Koichiro K Kawasaki Hiroaki H Hashimoto Ryota R
Psychiatry and clinical neurosciences 20201009 12
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Project description:AimAlthough treatment guidelines for pharmacological therapy for schizophrenia and major depressive disorder have been issued by the Japanese Societies of Neuropsychopharmacology and Mood Disorders, these guidelines have not been well applied by psychiatrists throughout the nation. To address this issue, we developed the 'Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE)' integrated education programs for psychiatrists to disseminate the clinical guidelines. Additionally, we conducted a systematic efficacy evaluation of the programs.MethodsFour hundred thirteen out of 461 psychiatrists attended two 1-day educational programs based on the treatment guidelines for schizophrenia and major depressive disorder from October 2016 to March 2018. We measured the participants' clinical knowledge of the treatment guidelines using self-completed questionnaires administered before and after the program to assess the effectiveness of the programs for improving knowledge. We also examined the relation between the participants' demographics and their clinical knowledge scores.ResultsThe clinical knowledge scores for both guidelines were significantly improved after the program. There was no correlation between clinical knowledge and participant demographics for the program on schizophrenia; however, a weak positive correlation was found between clinical knowledge and the years of professional experience for the program on major depressive disorder.ConclusionOur results provide evidence that educational programs on the clinical practices recommended in guidelines for schizophrenia and major depressive disorder might effectively improve participants' clinical knowledge of the guidelines. These data are encouraging to facilitate the standardization of clinical practices for psychiatric disorders.
| S-EPMC6852015 | biostudies-literature
Project description:BackgroundClinical practice guidelines for schizophrenia and major depressive disorder have been published. However, these have not had sufficient penetration in clinical settings. We developed the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project as a dissemination and education programme for psychiatrists.AimsThe aim of this study is to assess the effectiveness of the EGUIDE project on the subjective clinical behaviour of psychiatrists in accordance with clinical practice guidelines before and 1 and 2 years after participation in the programmes.MethodA total of 607 psychiatrists participated in this study during October 2016 and March 2019. They attended both 1-day educational programmes based on the clinical practice guidelines for schizophrenia and major depressive disorder, and answered web questionnaires about their clinical behaviours before and 1 and 2 years after attending the programmes. We evaluated the changes in clinical behaviours in accordance with the clinical practice guidelines between before and 2 years after the programme.ResultsAll of the scores for clinical behaviours in accordance with clinical practice guidelines were significantly improved after 1 and 2 years compared with before attending the programmes. There were no significant changes in any of the scores between 1 and 2 years after attending.ConclusionsAll clinical behaviours in accordance with clinical practice guidelines improved after attending the EGUIDE programme, and were maintained for at least 2 years. The EGUIDE project could contribute to improved guideline-based clinical behaviour among psychiatrists.
| S-EPMC9059732 | biostudies-literature
Project description:To disseminate, educate, and validate psychiatric clinical practice guidelines, the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project was launched in 2016. In this study, we investigated whether the web-based courses offered by this project would be as effective as the face-to-face courses. We analyzed and compared survey answers about overall participant satisfaction with the course and answers regarding clinical knowledge of schizophrenia and major depressive disorder between 170 participants who took the web-based courses in 2020 and 689 participants who took the face-to-face courses from 2016 to 2019. The web-based course participants completed the survey questions about satisfaction with the web-based courses. The web-based courses were conducted using a combination of web services to make it as similar as possible to the face-to-face courses. The degree of satisfaction assessed by the general evaluation of the web-based courses was higher than what was expected from the face-to-face courses. The degree of satisfaction was similar for the courses on schizophrenia and major depressive disorder. In addition, there were no significant differences in overall satisfaction and clinical knowledge between web-based and face-to-face courses. In conclusion, the web-based courses on clinical practice guidelines provided by the EGUIDE project were rated as more satisfying than the face-to-face course that the participants expected to take and no differences in the effectiveness of either course. The results suggest that, after the COVID-19 pandemic, it would be possible to disseminate this educational material more widely by adopting web-based courses additionally face-to-face courses.
| S-EPMC10009432 | biostudies-literature
Project description:BackgroundGuideline for Pharmacological Therapy for Schizophrenia was published by the Japanese Society of Neuropsychopharmacology in 2015. "Effectiveness of Guidelines for Dissemination and Education in psychiatric treatment (EGUIDE)" project aimed to standardize medical practice using quality indicators (QIs) as indices to evaluate the quality of medical practice. In this study, we have reported the quality indicator values of prescription before the beginning of the guideline lectures in the EGUIDE project to ascertain the baseline status of treating patients with schizophrenia.MethodsA cross-sectional, retrospective case record survey was conducted, involving 1164 patients with schizophrenia at the time of discharge. We checked all types and dosage of psychotropic drugs.ResultsForty-three percent of patients had antipsychotic polypharmacy, and substantial concomitant medication was observed (antidepressants; 8%, mood stabilizers: 37%, anxiolytics or hypnotics: 68%).ConclusionsIn the results obtained in this study, we plant to report changes in the effectiveness of education in the EGUIDE project near the future.
| S-EPMC7722678 | biostudies-literature
Project description:BackgroundSeveral guidelines recommend monotherapy in pharmacotherapy for schizophrenia and major depressive disorder. The content of regular prescriptions has been reported in several studies, but not enough research has been conducted on the content of pharmacotherapy, including pro re nata (PRN) medications. The purpose of this study was to evaluate the content of pharmacotherapy, including PRN medications, and to clarify the relationship with regular prescriptions.MethodsWe used data from the "Effectiveness of Guidelines for Dissemination And Education in psychiatric treatment" (EGUIDE) project to investigate the presence or absence of PRN psychotropic medications at discharge for each drug category. We compared the PRN psychotropic prescription ratio at discharge by diagnosis for each drug category. The antipsychotic monotherapy ratio and no prescription ratio of other psychotropics for schizophrenia at discharge and the antidepressant monotherapy ratio and no prescription ratio of other psychotropics for major depressive disorder at discharge were calculated for each regular prescription, including PRN psychotropic medications, as quality indicators (QIs). Spearman's rank correlation test was performed for QI values of regular prescriptions and the QI ratio between regular prescriptions and prescriptions including PRN medications for each diagnosis.ResultsThe PRN psychotropic prescription ratio at discharge was 28.7% for schizophrenia and 30.4% for major depressive disorder, with no significant differences by diagnosis. The prescription ratios of PRN antipsychotic medications and PRN antiparkinsonian medications were significantly higher for schizophrenia. The prescription ratios of PRN anxiolytic and hypnotic and PRN antidepressant medications were significantly higher for patients with major depressive disorder. For both schizophrenia and major depressive disorder, the QI was lower for discharge prescriptions, including PRN medications, than for regular prescriptions. QI values for regular prescriptions and the QI ratio were positively correlated.ConclusionsConsidering PRN psychotropic medications, the monotherapy ratio and no prescription ratio of other psychotropics at discharge decreased in pharmacotherapy for schizophrenia and major depressive disorder. A higher ratio of monotherapy and no prescription of other psychotropics on regular prescriptions may result in less concomitant use of PRN psychotropic medications. Further studies are needed to optimize PRN psychotropic prescriptions.
| S-EPMC9791735 | biostudies-literature
Project description:BackgroundPolypharmacy of additional psychotropics alongside the main treatment drug (antipsychotics in schizophrenia and antidepressants in major depressive disorder) is common in Japan. Our goal is to align psychotropic prescription in Japan with international standards, while reducing the differences between facilities. To achieve this goal, we aimed to compare prescriptions at the time of hospital admission and discharge.MethodsData on prescriptions at admission and discharge from 2016 to 2020 were collected. We divided the patients into four groups: (1) mono_mono group, monotherapy of the main drug at admission and discharge; (2) mono_poly group, monotherapy at admission and polypharmacy at discharge; (3) poly_poly group, polypharmacy at admission and discharge; and (4) poly_mono group, polypharmacy at admission and monotherapy at discharge. We compared the changes in dosage and number of psychotropics among the four groups.ResultsFor both schizophrenia and major depressive disorder, the patients who received monotherapy with the main drug at admission were likely to receive main drug monotherapy at discharge and vice versa. For schizophrenia, the polypharmacy was prescribed more often in the mono_poly group than that in the mono_mono group. The prescription was not changed at all for more than 10% of the patients.ConclusionsIt is critical to avoid a polypharmacy regimen to ensure that guideline-compliant treatment is provided. We expect higher rates of monotherapy with the main drug after the EGUIDE lectures.Trial registrationThe study protocol was registered in the University Hospital Medical Information Network Registry (UMIN000022645).
| S-EPMC10308621 | biostudies-literature
Project description:PurposeThis study aimed to describe the system of continuing medical education (CME) in the Guangxi Zhuang Autonomous Region and to ascertain the perceived needs related to that system, in order to improve the performance of health professionals in Chinese township health centers (THCs).MethodsIn-depth key informant interviews were conducted to gain insights into the current CME system. A cross-sectional survey using a self-administered structured questionnaire was also carried out from March to August 2014 in order to identify perceived needs among THC personnel in the Guangxi Zhuang Autonomous Region. Logistic regression was used to identify factors related to respondents' interest in pursuing different levels of degree study.ResultsThe areas of need perceived by the respondents included general clinical competence and emergency or first aid knowledge. Most respondents wanted to study at medical colleges in order to obtain a higher degree. Respondents aged below 45 years with neutral or positive attitudes about the benefit of degree study for the licensure examination were more likely to attend a bachelor-level CME program than their older peers and respondents with negative attitudes towards degree study. Female respondents and respondents aged below 45 years were more likely to attend a junior college CME program than males and older respondents, respectively.ConclusionIt is necessary to develop degree-linked CME programs to meet the need for young health professionals in Chinese THCs; therefore, this programs can improve the expertise of poorly educated young health workers, who overwhelm rural Chinese heath systems.
| S-EPMC4536342 | biostudies-literature
Project description:BackgroundTo implement clinical practice guidelines (CPGs), it is necessary for psychiatrists to deepen their understanding of the CPGs. The Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project is a nationwide dissemination and implementation study of two sets of CPGs for schizophrenia and major depressive disorder (MDD).MethodsA total of 413 psychiatrists (n = 212 in 2016; n = 201 in 2017) learned the two CPGs in the education program of the EGUIDE project, and clinical knowledge of these CPGs was evaluated at baseline and after the programs. To improve the correct answer rate for clinical knowledge after the programs, we revised the lecture materials associated with items that had a low correct answer rate in 2016 and used the revised lecture materials with the CPGs in 2017. The rates of correct answers after the programs between the 2016 and 2017 groups were compared.ResultsThe correct answer rate of one item on the schizophrenia CPG and one item on the MDD CPG tended to be improved (S-D5 and D-C6) and that of one on the MDD CPG was significantly improved (D-D3, P = 0.0008) in the 2017 group compared to those in the 2016 group.ConclusionsWe reported improvements in clinical knowledge of CPGs after the EGUIDE program in the 2017 group following revision of the lecture materials based on results from the 2016 group. These attempts to improve the degree of understanding of CPGs may facilitate the successful dissemination and implementation of psychiatric guidelines in everyday practice.
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