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Multicenter Study
. 2024 May 29;24(1):399.
doi: 10.1186/s12888-024-05816-x.

The effect of education regarding treatment guidelines for schizophrenia and major depressive disorders on psychiatrists' hypnotic medication prescribing behavior: a multicenter study

Toshinori Nakamura #  1 , Ryuji Furihata #  2 , Naomi Hasegawa  3 , Fumitoshi Kodaka  3   4 , Hiroyuki Muraoka  5 , Kayo Ichihashi  6 , Shinichiro Ochi  7 , Shusuke Numata  8 , Takashi Tsuboi  9 , Manabu Makinodan  10 , Hitoshi Iida  11 , Toshiaki Onitsuka  12 , Hiroko Kashiwagi  3   13 , Masahiro Takeshima  14 , Naoki Hashimoto  15 , Tatsuya Nagasawa  16 , Masahide Usami  17 , Hirotaka Yamagata  3   18 , Yoshikazu Takaesu  19 , Kenichiro Miura  3 , Junya Matsumoto  3 , Kazutaka Ohi  20 , Hisashi Yamada  3   21 , Hikaru Hori  11 , Ken Inada  5 , Koichiro Watanabe  9 , Ryota Hashimoto  3 , Norio Yasui-Furukori  22
Affiliations
Multicenter Study

The effect of education regarding treatment guidelines for schizophrenia and major depressive disorders on psychiatrists' hypnotic medication prescribing behavior: a multicenter study

Toshinori Nakamura et al. BMC Psychiatry. .

Abstract

Background: To examine whether the "Effectiveness of Guideline for Dissemination and Education in psychiatric treatment (EGIUDE)" project affects the rate of prescriptions of hypnotic medication and the type of hypnotic medications prescribed among psychiatrists, for schizophrenia and major depressive disorder in Japan.

Methods: The EGUIDE project is a nationwide prospective study of evidence-based clinical guidelines for schizophrenia and major depressive disorder in Japan. From 2016 to 2021, clinical and prescribing data from patients discharged from hospitals participating in the EGUIDE project were used to examine hypnotic medication prescriptions The prescribing rate of hypnotics and the prescribing rate of each type of hypnotic (benzodiazepine receptor agonist, nonbenzodiazepine receptor agonist, melatonin receptor agonist, and orexin receptor antagonist) were compared among patients who had been prescribed medication by psychiatrists participating in the EGUIDE project and patients who had been prescribed medication by nonparticipating psychiatrists. Multivariate logistic regression analysis was performed to examine the effect of the EGUIDE project on the prescription of hypnotic medications.

Results: A total of 12,161 patients with schizophrenia and 6,167 patients with major depressive disorder were included. Psychiatrists participating in the EGUIDE project significantly reduced the rate of prescribing hypnotic medication and benzodiazepine receptor agonists for both schizophrenia (P < 0.001) and major depressive disorder (P < 0.001) patients.

Conclusion: This is the first study to investigate the educational effects of guidelines for the treatment of psychiatric disorders on psychiatrists in terms of prescribing hypnotic medications to patients. The EGUIDE project may play an important role in reducing hypnotic medication prescription rates, particularly with respect to benzodiazepine receptor agonists. The results suggest that the EGUIDE project may result in improved therapeutic behavior.

Keywords: Clinical practice guideline; Hypnotic medication; Major depressive disorders; Psychiatrist; Schizophrenia.

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Conflict of interest statement

The authors declare no competing interests.

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Flowchart of patient inclusion
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