{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:16:16Z","timestamp":1789388176592,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP16dk0307060"],"award-info":[{"award-number":["JP16dk0307060"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP19dk0307083"],"award-info":[{"award-number":["JP19dk0307083"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP22dk0307112"],"award-info":[{"award-number":["JP22dk0307112"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP21K17261"],"award-info":[{"award-number":["JP21K17261"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP23K16273"],"award-info":[{"award-number":["JP23K16273"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neuropsychopharm Rep"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The Effectiveness Research on the Dissemination and Education of Psychiatric Clinical Practice Guidelines (EGUIDE Project) was launched in Japan to promote guideline\u2010adherent treatment for schizophrenia and major depressive disorder (MDD) through educational outreach programs. Although short\u2010term effects on participating physicians have been reported, the long\u2010term and facility\u2010wide effects remain unclear. This study evaluated whether guideline\u2010compliant treatment behaviors improved across institutions over time, indicating potential diffusion or spillover effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational study involving 298 psychiatric facilities between 2016 and 2023. Discharge prescriptions and treatment data were collected for 19\u2009623 patients with schizophrenia and 9805 patients with MDD. Adherence to the guidelines was assessed using 11 schizophrenia quality indicators (QI\u2010S) and seven MDD quality indicators (QI\u2010D). We performed logistic regression analyses, adjusting for age, sex, and facility type, with Bonferroni correction for multiple comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For schizophrenia, significant year\u2010on\u2010year improvements were observed in seven of the 11 QI\u2010S, including assessment of treatment\u2010resistant 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\u2010D 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\u2010term behavioral changes across all facilities, extending even to nonparticipating clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The presence of EGUIDE\u2010trained psychiatrists was associated with sustained improvements in guideline\u2010compliant treatments at the institutional level. These results imply not only individual educational benefits but also a diffusion of practice culture\u2014that is, a spillover effect\u2014leading to enhanced quality of psychiatric care. Continued educational efforts are essential to improving treatment practices at scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The protocol for the EGUIDE Project is registered with the University Hospital Medical Information Network Registry (UMIN000022645)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/npr2.70067","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T14:37:52Z","timestamp":1761662272000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Long\u2010Term Impact of\n                    <scp>EGUIDE<\/scp>\n                    Training on Facility\u2010Wide Guideline Adherence Rate in Schizophrenia and Major Depressive Disorder: A Multicenter Study"],"prefix":"10.1002","volume":"45","author":[{"given":"Naomi","family":"Hasegawa","sequence":"first","affiliation":[{"name":"Department of Pathology of Mental Diseases, National Institute of Mental Health National Center of Neurology and Psychiatry  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Muraoka","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Kitasato University, School of Medicine  Sagamihara Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3155-6971","authenticated-orcid":false,"given":"Yusuke","family":"Arai","sequence":"additional","affiliation":[{"name":"Department of Community Mental Health Shinshu University School of Medicine  Matsumoto Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Horinouchi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Hokkaido University Graduate School of Medicine  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Yamamuro","sequence":"additional","affiliation":[{"name":"Center for Health Control Nara Medical University  Kashihara Nara Japan"},{"name":"Department of Psychiatry Nara Medical University, School of Medicine  Kashihara Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Hokkaido University Graduate School of Medicine  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Ochi","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry, Molecules and Function Ehime University Graduate School of Medicine  Toon Ehime 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