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The Effectiveness of the Guidelines for Dissemination and Education (EGUIDE) project was established to promote sustained evidence\u2010based practice through a multilayered educational program for psychiatrists in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This multicenter observational study longitudinally tracked psychiatrists' self\u2010rated clinical behavior (CB) scores related to guideline adherence for up to 8\u2009years after initial EGUIDE participation. CB was assessed using a validated questionnaire covering general guideline use (CB\u2010G), schizophrenia (CB\u2010S), and major depressive disorder (CB\u2010D), with a comprehensive index (CB\u2010C) representing the mean of all domains. Data were analyzed using the Kruskal\u2013Wallis test, the Mann\u2013Whitney U test, and the Bonferroni correction (two\u2010tailed\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1562 psychiatrists (mean age, 32.7\u2009\u00b1\u20097.1\u2009years) were included. All CB indices (CB\u2010C, CB\u2010G, CB\u2010S, and CB\u2010D) significantly improved post training compared with the baseline (H\u2009=\u2009831.2\u2013984.0; all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u200910\n                      <jats:sup>\u221272<\/jats:sup>\n                      ), with small\u2010to\u2010moderate effect sizes (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.09\u20130.29). These improvements were maintained throughout the 8\u2010year follow\u2010up, with no significant decline, and several domains showed small but continued increases between 3 and 7\u2009years post training.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The EGUIDE program achieved long\u2010term, sustained improvements in psychiatrists' guideline\u2010adherent clinical behaviors through an integrated system combining education, supervision, feedback, and follow\u2010up. This autonomous, cyclical framework represents a high\u2010impact model for continuous quality improvement and may be adaptable to other medical specialties.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/npr2.70095","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:26:49Z","timestamp":1773030409000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Eight\u2010Year Progression of Clinical Practice Implementation Following Guideline Training in the\n                    <scp>EGUIDE<\/scp>\n                    Project"],"prefix":"10.1002","volume":"46","author":[{"given":"Kenta","family":"Ide","sequence":"first","affiliation":[{"name":"Department of Hospital Pharmacy Hospital of University of Occupational and Environmental Health  Kitakyushu, Fukuoka Japan"},{"name":"Department of Pathology of Mental Diseases, National Institute of Mental Health National Center of Neurology and Psychiatry  Kodaira, Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4362-3262","authenticated-orcid":false,"given":"Kazuhiko","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":"Hisashi","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Pathology of Mental Diseases, National Institute of Mental Health National Center of Neurology and Psychiatry  Kodaira, Tokyo Japan"},{"name":"Department of Neuropsychiatry Hyogo Medical University  Nishinomiya Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Pathology of Mental Diseases, National Institute of Mental Health National Center of Neurology and Psychiatry  Kodaira, Tokyo 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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6728-5341","authenticated-orcid":false,"given":"Hiroyuki","family":"Muraoka","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Kitasato University School of Medicine  Sagamihara Kanagawa 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 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