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The Personal Antipsychotic Choice Index
Floor van Dijk1, Iris de Wit1, Matthijs Blankers2,3
1Department Early Psychosis, Academical Medical Centre of the University of Amsterdam, Amterdam, the Netherlands.
Pharmacopsychiatry
|August 16, 2017
Summary
This study introduces a shared decision-making tool for patients with psychotic disorders to select antipsychotic medications. The online aid personalizes medication rankings based on patient-valued effectiveness and adverse effect criteria.
Area of Science:
- Psychiatry
- Pharmacology
- Health Informatics
Background:
- Shared decision-making is crucial for patients with psychotic disorders.
- Antipsychotic medication selection involves complex choices regarding efficacy and side effects.
Purpose of the Study:
- To develop and present an online decision aid for shared decision-making in antipsychotic medication selection.
- To empower patients in choosing treatments based on personalized preferences.
Main Methods:
- Patients selected criteria (effectiveness, adverse effects) using the Subject's Response to Antipsychotics-34 questionnaire.
- Antipsychotics were ranked based on numerical data from meta-analyses, clinical trials, receptor affinities, and expert opinions.
- A personalized ranking was generated by combining patient-input Likert scale values with antipsychotic rank orders via an algorithm.
Main Results:
- Key criteria included effectiveness (psychotic, depressive, cognitive symptoms) and adverse effects (weight gain, sexual dysfunction, drowsiness, etc.).
- High-level evidence supported rankings for weight gain, sexual dysfunction, menstrual disorders, extrapyramidal symptoms, and psychotic symptom effectiveness.
- Lower-level evidence was used for ranking remaining criteria.
Conclusions:
- A transparent, updateable tool was developed for individual antipsychotic ranking.
- The tool facilitates patient involvement in selecting antipsychotic medications based on personal values.
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