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Pharmacopsychiatry 2018; 51(03): 89-99
DOI: 10.1055/s-0043-116854
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

The Personal Antipsychotic Choice Index

Introducing a Tool for Shared Decision-Making in Selecting Antipsychotic Medication
Floor van Dijk
1   Department Early Psychosis, Academical Medical Centre of the University of Amsterdam, Amterdam, the Netherlands
,
Iris de Wit
1   Department Early Psychosis, Academical Medical Centre of the University of Amsterdam, Amterdam, the Netherlands
,
Matthijs Blankers
2   Department of Research, Arkin Mental Health Care, Amsterdam, the Netherlands
3   Trimbos-institute, the Netherlands institute of mental health and addiction, Utrecht, the Netherlands
,
Iris Sommer
4   Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht, The Netherlands
,
Lieuwe de Haan
1   Department Early Psychosis, Academical Medical Centre of the University of Amsterdam, Amterdam, the Netherlands
› Author Affiliations
Further Information

Publication History

received 13 December 2016
revised 15 May 2017

accepted 13 July 2017

Publication Date:
15 August 2017 (online)

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Abstract

Introduction We present an online decision aid to involve patients with a psychotic disorder in shared decision-making concerning the selection of antipsychotic medication.

Method Patients selected effectiveness and adverse effects criteria from the Subject’s Response to Antipsychotics-34 questionnaire. Numerical data from meta-analyses, clinical trial data, receptor affinities and expert opinions were used to rank antipsychotics on each criterion. When using the the tool, patients indicate on a 5-point Likert scale how they value each (adverse) effect. The Likert scale values are combined in an algorithm with the rank orders of antipsychotics to create a personalized ranking.

Results Criteria used were: effectiveness concerning psychotic, depressive and cognitive symptoms, weight gain, sexual dysfunction, drowsiness, hypersomnia, extrapyramidal symptoms, anticholinergic adverse effects, hypersalivation, nausea, dizziness, energy loss, blunted affect/less need for companionship. High-level evidence was available for ranking weight gain, sexual dysfunction, menstrual disorders, extrapyramidal symptoms and effectiveness on psychotic symptoms. We used lower level evidence ranking the remaining criteria.

Discussion A transparent procedure has resulted in an updateable tool to produce individual ranking of antipsychotics based on the patients’ input.

Key words

antipsychotics - psychosis - shared decision making - adherence - web tool

Supporting Information

 

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