領域・職種を超えて取り組む抗不安薬の出口戦略 DOI Open Access
Yoshikazu Takaesu, Hisashi Yamada, Kenya Ie

и другие.

Anxiety Disorder Research, Год журнала: 2023, Номер 15(1), С. 20 - 30

Опубликована: Ноя. 30, 2023

ベンゾジアゼピン受容体作動薬(BZD)の抗不安薬は精神科・心療内科に限らず,広く一般診療科で処方されている。同薬剤の多剤併用・長期処方による依存形成のリスク,認知機能低下,転倒リスクの増大などが指摘されているが,実臨床においていったん多剤併用・長期処方に陥ると,身体依存により減薬は容易ではなく,長期処方から脱却できないケースも少なくない。そのため,我々は抗不安薬の出口戦略の実装化に向けて,令和3年度~4年度にかけて厚労科研研究「睡眠薬・抗不安薬の処方実態調査ならびに共同意思決定による適正使用・出口戦略のための研修プログラムの開発と効果検証研究」を実施した。本研究では多領域・多職種による取り組みにより臨床現場におけるBZDの実践的指針としてエキスパートコンセンサスの作成し,BZD適正使用・出口戦略の研修プログラムを開発することにより実装化を目指した。

Relationships between clinician adherence to guideline-recommended treatment and memory function in patients with schizophrenia DOI Creative Commons
Yasushi Kawamata, Kazutaka Ohi, Satsuki Ito

и другие.

Journal of Psychiatric Research, Год журнала: 2025, Номер 185, С. 169 - 176

Опубликована: Март 29, 2025

Memory function impairment is severe in patients with schizophrenia, but improving memory remains challenging. The use of benzodiazepines and anticholinergics, which are not recommended by pharmacological therapy guidelines for has been associated worsened cognitive function. However, it unclear whether better adherence psychiatrists to schizophrenia improved Therefore, we investigated the relationship between psychiatrists' schizophrenia. To evaluate associations function, utilized Individual Fitness Score (IFS), includes multiple quality indicators, assess each psychiatrist's these treating patient. was measured using Wechsler Scale-Revised a total 351 patients, including 40 treatment-resistant (TRS) 311 non-TRS. We found that psychiatrist significantly positively correlated verbal (β = 0.145, p 6.45 × 10-3), attention/concentration 0.138, 0.010), delayed recall 0.167, 1.57 10-3) all Additionally, nominal positive correlation observed visual 0.124, 0.019). In non-TRS 0.166, 3.17 nominally 0.141, 0.013) 0.114, 0.044) functions. contrast, no significant were any functions TRS. These findings suggest enhancing guideline education might improve impairments

Язык: Английский

Процитировано

0

Associations between clozapine availability, the diagnosis of treatment-resistant schizophrenia subgroups, antipsychotic monotherapy, and concomitant psychotropics among patients with schizophrenia: a real-world nationwide study DOI Creative Commons
Shinichiro Ochi, Fumitoshi Kodaka, Naomi Hasegawa

и другие.

The International Journal of Neuropsychopharmacology, Год журнала: 2025, Номер 28(4)

Опубликована: Март 28, 2025

The rate of antipsychotic polypharmacy is high. One risk factor for may be the severity schizophrenia, including treatment-resistant schizophrenia (TRS). We hypothesized that institutions are able to prescribe clozapine present differences in pharmacological treatment even before TRS diagnosed. A total 8155 patients with were divided into clozapine-available institution (CAI) group and clozapine-unavailable (CUI) group. psychotropic prescription rates at discharge compared between two groups. Furthermore, investigate whether diagnosis subgroups influenced efficacy, we CAIs CUIs descriptions (DSTRS) those without (NDSTRS). Compared CUI group, both monotherapy (58.3% vs. 50.7%; p = 2.4 × 10-7) concomitant use other psychotropics (20.4% 15.6%; 3.8 10-5) significantly higher CAI DSTRS (63.3%) was than NDSTRS (54.5%; 1.4 10-12), (49.6%; 4.9 10-9), (50.9%; 2.0 10-8). (22.6%) also (18.7%; 4.7 10-4), (15.9%; 5.5 (15.2%; 8.0 10-5). There no significant difference these Both availability prescriptions precise can promote development an organizational culture facilitates schizophrenia.

Язык: Английский

Процитировано

0

Practice Guidelines for Bipolar Disorder by the JSMD (Japanese Society of Mood Disorders) DOI Creative Commons
Tadafumi Kato, Kazuyoshi Ogasawara,

Keisuke Motomura

и другие.

Psychiatry and Clinical Neurosciences, Год журнала: 2024, Номер 78(11), С. 633 - 645

Опубликована: Авг. 28, 2024

The Japanese Society of Mood Disorders (JSMD) published treatment guidelines bipolar disorder in 2011. present incorporating new findings were developed to comply the National Academy Medicine (NAM) by utilizing systematic reviews and meta‐analysis taking patient family opinions as well insights from multiple professional fields into account. They support combination therapy using mood stabilizers second‐generation antipsychotics many aspects. also have limitations, including grouping when was performed despite their distinct properties, due scarcity drug‐specific evidence. Despite these provide clinical decision for psychiatrists Japan.

Язык: Английский

Процитировано

3

Effect of the guideline education program on anticholinergic and benzodiazepine use in outpatients with schizophrenia and major depressive disorder: The effectiveness of guidelines for dissemination and education in psychiatric treatment (EGUIDE) project DOI Creative Commons
Hirotaka Yamagata, Yuko Fujii, Shinichiro Ochi

и другие.

Psychiatry Research Communications, Год журнала: 2024, Номер 4(1), С. 100158 - 100158

Опубликована: Фев. 5, 2024

Reports on polypharmacy strategies for patients with schizophrenia and major depressive disorder (MDD) are scarce. The nationwide Effectiveness of Guidelines Dissemination Education in Psychiatric Treatment (EGUIDE) project has been used to train psychiatrists the guidelines treatment MDD. This study aimed determine whether EGUIDE program enabled more appropriate evidence-based outpatients types doses all psychotropics were analyzed 174 147 MDD, respectively, 2018 before 2019 2020 after program. There no significant differences rate monopharmacy antipsychotics schizophrenia; however, prescriptions first-generation antipsychotics, anticholinergics, benzodiazepines decreased significantly also antidepressant rates MDD; MDD Significant positive correlations found between number psychotropic dosage benzodiazepines. In conclusion, improved prescribing behavior depression. Therefore, guideline training may be useful regulating among physicians.

Язык: Английский

Процитировано

1

The effect of education regarding treatment guidelines for schizophrenia and major depressive disorders on psychiatrists' hypnotic medication prescribing behavior: a multicenter study DOI Creative Commons
Toshinori Nakamura, Ryuji Furihata, Naomi Hasegawa

и другие.

BMC Psychiatry, Год журнала: 2024, Номер 24(1)

Опубликована: Май 29, 2024

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

Язык: Английский

Процитировано

0

Integrating psychiatry into basic clinical skills: A three‐year nationwide quantitative assessment of postgraduate training programs DOI Creative Commons
Hidetaka Tamune, Hirohisa Fujikawa, H. Harada

и другие.

Psychiatry and Clinical Neurosciences Reports, Год журнала: 2024, Номер 3(4)

Опубликована: Сен. 25, 2024

Abstract Aim The aim of this study was to develop quantitative outcome indicators for psychiatric training programs integrated into the General Medicine In‐Training Examination (GM‐ITE) and investigate which characteristics correlate with high scores in psychiatry. Methods A nationwide cross‐sectional conducted over 3 fiscal years (2021–2023). An anonymous online questionnaire distributed postgraduate year 1 2 residents who completed GM‐ITE. primary GM‐ITE score, a particular focus on Multiple‐choice questions psychiatry field were created by board‐certified psychiatrists various subspecialties, then reviewed piloted. Multiple regression analysis examined correlations between score resident facility characteristics. Results total 18,226 participated years, whom 5%–6% aspired specialize Quantitative effective across all years. Psychiatry aspirants had lower internal medicine, emergency, but higher Residents from university hospitals scores, while number beds supervising did not scores. These findings indicate need distinct general medicine emergency training. Conclusion Based these highlights necessity improving physical assessment skills during residency aspirants, Future research should identify practices that lead among residents, thereby better integrate basic clinical skills.

Язык: Английский

Процитировано

0

The association between benzodiazepine prescriptions and the risk of laxative use in schizophrenia treatment DOI Creative Commons
Shinichiro Ochi, Takashi Tsuboi, Naomi Hasegawa

и другие.

Neuropsychopharmacology Reports, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 7, 2024

Constipation is one of the most common adverse effects in schizophrenia treatment, and it can sometimes cause severe gastrointestinal disease. However, results association studies between constipation psychotropic medications patients with are inconsistent. Therefore, we investigated characteristics laxative prescriptions at discharge to clarify psychotropics constipation.

Язык: Английский

Процитировано

0

領域・職種を超えて取り組む抗不安薬の出口戦略 DOI Open Access
Yoshikazu Takaesu, Hisashi Yamada, Kenya Ie

и другие.

Anxiety Disorder Research, Год журнала: 2023, Номер 15(1), С. 20 - 30

Опубликована: Ноя. 30, 2023

ベンゾジアゼピン受容体作動薬(BZD)の抗不安薬は精神科・心療内科に限らず,広く一般診療科で処方されている。同薬剤の多剤併用・長期処方による依存形成のリスク,認知機能低下,転倒リスクの増大などが指摘されているが,実臨床においていったん多剤併用・長期処方に陥ると,身体依存により減薬は容易ではなく,長期処方から脱却できないケースも少なくない。そのため,我々は抗不安薬の出口戦略の実装化に向けて,令和3年度~4年度にかけて厚労科研研究「睡眠薬・抗不安薬の処方実態調査ならびに共同意思決定による適正使用・出口戦略のための研修プログラムの開発と効果検証研究」を実施した。本研究では多領域・多職種による取り組みにより臨床現場におけるBZDの実践的指針としてエキスパートコンセンサスの作成し,BZD適正使用・出口戦略の研修プログラムを開発することにより実装化を目指した。

Процитировано

0