Using algorithms to initiate needs-based interventions for people on antipsychotic medication: implementation protocol

Introduction: Non-adherence to antipsychotic medications for individuals with serious mental illness increases risk of relapse and hospitalisation. Real time monitoring of adherence would allow for early intervention. AI² is a both a personal nudging system and a clinical decision support tool that applies machine learning on Medicare prescription and benefits data to raise alerts when patients have discontinued antipsychotic medications without supervision, or when essential routine health checks have not been performed.

Methods and analysis: We outline two intervention models using AI². In the first use-case, the personal nudging system, patients receive text messages when an alert of a missed medication or routine health check is detected by AI². In the second use-case, as a clinical decision support tool, AI² generated alerts are presented as flags through a dashboard to the community mental health professionals. Implementation protocols for different scenarios of AI², along with a mixed-methods evaluation, are planned to identify pragmatic issues necessary to inform a larger randomised control trial, as well as improve the application.

Ethics and dissemination: This study protocol has been approved by The Southern Adelaide Clinical Human Research Ethics Committee. The dissemination of this trial will serve to inform further implementation of the AI² into daily personal and clinical practice.