Evidence map›Paper›PMID 31310188›Full record

ArticlePsychiatric services (Washington, D.C.)2019

Designing Safer Use of Antipsychotics Among Youths: A Human-Centered Approach to an Algorithm-Based Solution.

Andrea L Hartzler, James D Ralston, Terry A Hannan, Kelly J Kelleher, Robert B Penfold

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Psychiatric services (Washington, D.C.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Safer and targeted use of antipsychotics in youth: an embedded, pragmatic randomized trial.Journal of child psychology and psychiatry, and allied disciplines · 2025
    Trial
  2. Article
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Andrea L HartzlerDepartment of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle (Hartzler); Kaiser Permanente Washington Health Research Institute, Seattle (Ralston, Hannan, Penfold); Nationwide Children's Hospital, Abigail Wexner Research Institute, Center for Innovation in Pediatric Practice, Columbus, Ohio (Kelleher).
James D RalstonDepartment of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle (Hartzler); Kaiser Permanente Washington Health Research Institute, Seattle (Ralston, Hannan, Penfold); Nationwide Children's Hospital, Abigail Wexner Research Institute, Center for Innovation in Pediatric Practice, Columbus, Ohio (Kelleher).
Terry A HannanDepartment of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle (Hartzler); Kaiser Permanente Washington Health Research Institute, Seattle (Ralston, Hannan, Penfold); Nationwide Children's Hospital, Abigail Wexner Research Institute, Center for Innovation in Pediatric Practice, Columbus, Ohio (Kelleher).
Kelly J KelleherDepartment of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle (Hartzler); Kaiser Permanente Washington Health Research Institute, Seattle (Ralston, Hannan, Penfold); Nationwide Children's Hospital, Abigail Wexner Research Institute, Center for Innovation in Pediatric Practice, Columbus, Ohio (Kelleher).
Robert B PenfoldDepartment of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle (Hartzler); Kaiser Permanente Washington Health Research Institute, Seattle (Ralston, Hannan, Penfold); Nationwide Children's Hospital, Abigail Wexner Research Institute, Center for Innovation in Pediatric Practice, Columbus, Ohio (Kelleher).

Funding

Intramural NIH HHS Z99 DA999999NIDA NIH HHS HHSN271201600002C
6 · The paper itself

Abstract

objectiveGuidelines recommend against prescribing antipsychotics without an indication, yet prescription rates remain undesirably high for youths. Information technology can facilitate guideline-based prescribing, but little is known about providers' needs. The Safer Use of Antipsychotics in Youth project is implementing an algorithm-based workflow for peer consultation, care navigation, and expedited psychotherapy access. To optimize workflow for a multisite trial, we engaged providers for input.

methodsGuided by human-centered design, we interviewed 15 providers from Kaiser Permanente Washington and Nationwide Children's Hospital about their prescribing barriers and workflow preferences. We identified qualitative themes on barriers affecting implementation and design opportunities to optimize workflow.

resultsProviders expressed two major barriers: potential disruptions to clinical practice and threats to professional autonomy. Three design opportunities emerged: à la carte orders, passive review of orders, and consultation self-acknowledgment.

conclusionsHuman-centered design offers an innovative approach to improve guideline-based prescribing with optimizations that are grounded in providers' needs.

Indexed as

Electronic Health RecordsPatient-Centered CareWorkflowAlgorithmsAntipsychotic AgentsAttitude of Health PersonnelDrug PrescriptionsHumansMental DisordersPractice Guidelines as TopicYoung AdultAntipsychotic AgentsAntipsychoticsClinical decision support systemsDrug PrescribingPediatrics. Electronic health recordsSoftware designUser-computer interfaceWorkflow

Identifiers

PMID31310188
PMCPMC6773473

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.