The Treatment of Schizophrenia using antipsychotics (drugs used to treat psychological disorder) has several side effects at various severities. Knowing the tolerance of patients to these side effects remarkably helps psychotherapists to select the most effective and endurable medicines accordingly. Therefore, this Thesis proposed a Web-based application to realize a Shared Decision Making (SDM) approach that involves both patient and psychotherapist in the prescription of antipsychotics. Specifically, patients specify their tolerable degree to each side effect, which will serve as thresholds to rank antipsychotics based one their efficacy and severity of side effects. The study will evaluate the usability of the web application from the perspectives of patients and psychotherapists. The potential participants to evaluate the web application are research assistants / psychotherapists at Klinikum rechts der Isar (MRI).
Schizophrenia is a mental disorder which disables the behavior, perception and feeling of an individual to reality [1]. Antipsychotics applied in the treatment of schizophrenia are effective in controlling or mitigating certain adverse psychological activities, yet they can cause a number of side effects at various probability. Communicating the side effects and efficacy of antipsychotics to patients can remarkably improve the treatment quality. Since both psychologists patients are informed about the likelihood and presence of certain unwanted reactions, they can select the antipsychotics that are both effective and acceptable. This practice is called Shared Decision Making (SDM), as both medical experts and patients collaborate on the selection of medicine for the treatment.
The SDMA is a Web Application that supports the management and execution of SDM sessions. SDMA systematically, interactively, and intuitively displays the efficacy along with side effects of various antipsychotics to patients and medical experts. The SDMA executes three steps of the SDM process:
Step 1: Input concerning side effects from the patient's perspective, and medical data (e.g. previously used antipsychotics, comorbidities, etc.)
Step 2: Select antipsychotics based on their evidence-based information of efficacy and plausibility of side effects occurence. Medical experts consult the patients based on their health condition, preferences of side effects, and pharmaceutical effects of antipsychotics.
Step 3: Finalize the selection of antipsychotics. Optionally, medical experts can add supplemental medicine that is necessary for the treatment.
Besides the implementation of technical features, SDMA has to consider the regulation of data protection into the system development. This means patient data are processed such that they do not directly reveal the identity of patients, which can expose their medical information.
The SDMA system is under evaluation for the treatment of schizophrenic patients at the MRI clinics.
Besides the treatment of schizophrenia, the SDMA can also be adapted for other therapies of curing cancers, heart diseases, obesity, etc., by presenting the efficacy and side effects of various medicines. This will help doctors and patients to expect or avoid potential risks in using certain drugs.
References
[1] The National Institute of Mental Health Information Resource Center, 2020, Schizophrenia. https://www.nimh.nih.gov/health/topics/schizophrenia/