Reviewing the Understanding of the Treatment Guidelines for Schizophrenia & Major Depressive Disorder

Research Paper Title

Improvements in the degree of understanding of the treatment guidelines for schizophrenia and major depressive disorder in a nationwide dissemination and implementation study.

Background

To 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).

Methods

A 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 programmes between the 2016 and 2017 groups were compared.

Results

The 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.

Conclusions

The researchers 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.

Reference

Numata, S., Nakataki, M., Hasegawa, N., Takaesu, Y., Takeshima, M., Onitsuka, T., Nakamura, T., Edagawa, R., do, H., Miura, K., Matsumoto, J., Yasui-Fiurukori, N., Kishimoto, T., Hori, H., Tsuboi, T., Yasuda, Y., Furihata, R., Muraoka, H., Ochi, S., Nagasawa, T., Kyou, Y., Murata, A., Katsumoto, E., Ohi, K., Hishimoto, A., Inada, K., Watanabe, K. & Hashimoto, R. (2021) Improvements in the degree of understanding the treatment guidelines for schizophrenia and major depressive disorder in a nationwide dissemination and implementation study. Neuropsychopharmacology Reports. doi: 10.1002/npr2.12173. Online ahead of print.

Can Internet-based Clinical Practice Guidelines aid in the Management of PTSD?

Research Paper Title

Randomized Controlled Trial of a Web-Based Intervention to Disseminate Clinical Practice Guidelines for Posttraumatic Stress Disorder: The PTSD Clinicians Exchange.

Background

Delivery of best-practice care for Post-Traumatic Stress Disorder (PTSD) is a priority for clinicians working with active duty military personnel and veterans.

The PTSD Clinicians Exchange, an Internet-based intervention, was designed to assist in disseminating clinically relevant information and resources that support delivery of key practices endorsed in the Veterans Administration (VA)-Department of Defence (DoD) Clinical Practice Guidelines (CPG) for the Management of Posttraumatic Stress.

Methods

The researchers conducted a randomised controlled trial to examine the effectiveness of the Clinicians Exchange intervention in increasing familiarity and perceived benefits of 26 CPG-related and emerging practices.

The intervention consisted of ongoing access to an Internet resource featuring best-in-class resources for practices, self-management of burnout, and biweekly e-mail reminders highlighting selected practices.

Mental health clinicians (N = 605) were recruited from three service sectors (VA, DoD, community); 32.7% of participants assigned to the Internet intervention accessed the site to view resources.

Results

Individuals who were offered the intervention increased their practice familiarity ratings significantly more than those assigned to a newsletter-only control condition, d = 0.27, p = .005.

From baseline to 12-months, mean familiarity ratings of clinicians in the intervention group increased from 3.0 to 3.4 on scale of 1 (not at all) to 5 (extremely); mean ratings for the control group were 3.2 at both assessments.

Clinicians generally viewed the CPG practices favourably, rating them as likely to benefit their clients.

Conclusions

The results suggest that Internet-based resources may aid more comprehensive efforts to disseminate CPGs, but increasing clinician engagement will be important.

Reference

Ruzek, J.I., Wilk, J., Simon, E., Marceau, L., Trachtenberg, F.L., Magnavita, A.M., Coleman, J.L., Ortigo, K., Ambrosoli, J., Zincavage, R., Clarke-Walper, K., Penix, E. & Rosen, R.C. (2020) Randomized Controlled Trial of a Web-Based Intervention to Disseminate Clinical Practice Guidelines for Posttraumatic Stress Disorder: The PTSD Clinicians Exchange. Journal of Traumatic Stress. 33(2), pp.190-196. doi: 10.1002/jts.22483. Epub 2020 Feb 26.