Psychopharmacology Algorithm Project Harvard Medical School
The main aim of this project is to improve the quality of
psychopharmacological thinking and care by promoting evidence-based practice
especially through the use of computerized algorithms. The evidence considered
includes high quality empirical research studies but also uncontrolled studies
and compilations of expert opinion and practice guidelines. The Project's
algorithms provide a base of knowledge to consider before making an
individualized determination of what is best for the patient. They are not a
set of rules to use without deviation.
At this time, the Project's staff has developed three Web-based
pharmacotherapy algorithms: Depression, Schizophrenia, and Anxiety Disorders in
Patients with Substance Abuse. Other decision support information available at
the site includes medication dosing strategies, side effect management, a
program which offers detailed information about cytochrome P450 drug
interactions that might occur when multiple drugs are prescribed, comparative
costs of different medications, and algorithms for assessing and managing
treatment compliance issues. All information is extensively referenced.
Virtual Consultation
Each algorithm program offers a virtual
consultation by asking the clinician questions about the patient. The reasoning
behind the sequence of questions is explained at each step. The questions
conclude with recommendations which are discussed and referenced, and the
merits and problems associated with alternatives to the first-line choices are
reviewed. Questions and recommendations are accompanied by clinical confidence
ratings which indicate the strength of scientific support for them.
The medication algorithms may be accessed at: www.mhc.com/Algorithms
The computerized
cytochrome P450 drug interactions program may be accessed at:
David Osser, M.D.
David Osser, M.D. is
General Editor, Psychopharmacology Algorithm Project, and Associate Professor
of Psychiatry, Harvard Medical School at the Harvard South Shore Residency
Training Program, Brockton VA Medical Center and Taunton State Hospital. Dr.
Osser is also Chair of the Psychopharmacology Training Committee in the Harvard
South Shore program. He is an author of over 50 academic products including
journal articles, book chapters, abstracts, and computer software for
decision-support in psychopharmacology, and he has won six awards for his
teaching. He consults internationally on aspects of psychopharmacology
algorithm development and his work has been translated into several languages.