title: Development of a Web-Based Clinical Decision Support System for Drug Prescription: Non-Interventional Naturalistic Description of the Antipsychotic Prescription Patterns in 4345 Outpatients and Future Applications.
abstract: OBJECTIVE
  The emergence of electronic prescribing devices with clinical decision support systems (CDSS) is able to significantly improve management pharmacological treatments. We developed a web application available on smartphones in order to help clinicians monitor prescription and further propose CDSS.
  
  
  METHODS
  A web application (www.MEmind.net) was developed to assess patients and collect data regarding gender, age, diagnosis and treatment. We analyzed antipsychotic prescriptions in 4345 patients attended in five Psychiatric Community Mental Health Centers from June 2014 to October 2014. The web-application reported average daily dose prescribed for antipsychotics, prescribed daily dose (PDD), and the PDD to defined daily dose (DDD) ratio.
  
  
  RESULTS
  The MEmind web-application reported that antipsychotics were used in 1116 patients out of the total sample, mostly in 486 (44%) patients with schizophrenia related disorders but also in other diagnoses. Second generation antipsychotics (quetiapine, aripiprazole and long-acting paliperidone) were preferably employed. Low doses were more frequently used than high doses. Long acting paliperidone and ziprasidone however, were the only two antipsychotics used at excessive dosing. Antipsychotic polypharmacy was used in 287 (26%) patients with classic depot drugs, clotiapine, amisulpride and clozapine.
  
  
  CONCLUSIONS
  In this study we describe the first step of the development of a web application that is able to make polypharmacy, high dose usage and off label usage of antipsychotics visible to clinicians. Current development of the MEmind web application may help to improve prescription security via momentary feedback of prescription and clinical decision support system.
authors.affiliation: Department of Psychiatry and Emergency, Brest Medical University Hospital, Brest, France.|Logics in Uses, Social Science and Information Science department, Telecom Bretagne, Plouzané, France.
authors.forename: Sofian
authors.initials: S
authors.lastname: Berrouiguet
authors.affiliation: Department of Psychiatry at Fundación Jimenez Diaz Hospital, Madrid, Spain.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Barrigón
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, United States of America.
authors.forename: Sara A
authors.initials: SA
authors.lastname: Brandt
authors.affiliation: Department of Psychiatry at Fundación Jimenez Diaz Hospital, Madrid, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Ovejero-García
authors.affiliation: Department of Psychiatry, University Hospital Rey Juan Carlos, Móstoles, Madrid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Álvarez-García
authors.affiliation: Department of Psychiatry at Fundación Jimenez Diaz Hospital, Madrid, Spain.
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: Carballo
authors.affiliation: Logics in Uses, Social Science and Information Science department, Telecom Bretagne, Plouzané, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lenca
authors.affiliation: INSERM U888, Department of Psychiatry, Montpellier University Hospital, Montpellier, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
authors.affiliation: Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain.|Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain.|Department of Psychiatry, University Hospital Rey Juan Carlos, Móstoles, Spain.|Department of Psychiatry, General Hospital of Villalba, Autonoma University, Madrid, Spain.|CIBERSAM, Madrid, Spain.|Columbia University, New York, NY, United States of America.
authors.forename: Enrique
authors.initials: E
authors.lastname: Baca-García
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003155:Community Mental Health Centers; D020000:Decision Support Systems, Clinical; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing; D020407:Internet; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D000068882:Paliperidone Palmitate / Q000627:therapeutic use; D010879:Piperazines; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy; D013844:Thiazoles; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D010879:Piperazines; D013844:Thiazoles; C092292:ziprasidone; D000068882:Paliperidone Palmitate