Development of a Predictive Model for Serious Adverse Drug Reaction in Psychiatric Patients Leading to the Use of Benztropine Injection by Using Data Mining Techniques

Abstract

Objective: To develop a predictive model for an occurrence of serious adverse drug reactions, especially acute dystonia, leading to an administration of benztropine injection in psychiatric patients. Methods: Data of patients diagnosed with ICD10 F00.00 - F99.99, aging between 15 - 80 years old were gathered from Somdet Chaopraya institute of psychiatry’s database from January 2016 to December 2021. Subsequently, the collected data were then processed by a data selection algorithm with a predetermined set of variables to analyze the association with serious adverse drug reaction leading to an administration of benztropine injection.  Data were then cleaned, and used to generate a predictive model by a decision tree method via RapidMiner Studio program. The program’s parameters were later adjusted for maximum precision. Results: This study gathered data of 41,713 patients with 5.47% of a serious adverse drug reaction leading to an administration of benztropine injection. A total of 164 variables were established with 16 being significant for generating the decision tree. The important first-class variable was an increase in antipsychotic drug dosage within 7 days which accounted for 91.39% of the serious adverse drug reaction. The other significant variables in the predictive model were the receiving of short-acting haloperidol injection or antipsychotic medication with a daily dosage equal to 5 mg/day of risperidone (sum DDD>5) with no concomitant anticholinergic drug. Development of the predictive model by a decision tree method from this study had shown to predict an occurrence of a serious adverse drug reaction with an accuracy of 84.32% and recall of 85.31%. Conclusion: Acute dystonia is a serious drug adverse reaction of antipsychotic medications with appropriate monitoring needed, particularly in patients with high-risk, i.e., those with the increased dosage of antipsychotic drugs within 7 days.