[Current Status of Clinical Practice Guidelines for Mental Health in Japan].

Abstract

In Japan, Clinical Practice Guidelines are defined as a document that presents appropriate recommendations to assist patients and practitioners in making decisions regarding clinical practice of marked importance, based on the body of evidence evaluated and integrated by systematic reviews and the balance between benefits and harm outlined by the Medical Information Network Distribution Services (Minds). Their successful implementation should improve the quality of care by decreasing inappropriate variation and expediting the application of effective advances to everyday practice. The process of developing CPGs includes dissemination, implementation, and assessment after publication. Some of the countries or guideline developers conducted research on factors of facilitators and barriers influencing the imple- mentation of CPGs. In Japanese mental health, little is known about the influence of CPGs. To gain an understanding of the current status of CPGs for mental health, we collected all published CPGs using the following databases: Minds website, Toho University and ICHUSHI Clinical Practice Guidelines Database, and J-GLOBAL. As a result, we found 1,117 articles. Because of the overlap among the 3 databases, trans- lated versions of foreign CPGs, commentaries, and review articles, 78 CPGs were extracted. We categorized the 78 CPGs into the following types : disease, writers, publication year, method of development, publication type, and revised or not. Through this survey, we found that there are many CPGs, they are difficult to identify, and their implementation and dissemination rates are unclear. CPGs are one type of medical information, and their use causes some challenges. When we develop CPGs, we have to per- form a systematic review of the evidence. It is known that there is a gap between evidence and practice in healthcare research. Also, multimorbidity is now very common. CPGs are gen- erally developed for a single disease, and so the application of CPGs is difficult when a patient has more than one disease. Although CPGs for mental health are being developed in Japan, there have been few studies on the influence, barriers, and facilitators of dissemination and implementation. Further research is needed on how to utiliz medical information effectively in order to improve the quality of health care.