Compliance with the guidelines for laboratory monitoring of patients treated with lithium: A retrospective follow-up study among ambulatory patients in the Netherlands.
Autor: | Nederlof M; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.; Brocacef Ziekenhuisfarmacie, Maarssen, The Netherlands., Egberts TC; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.; Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands., van Londen L; Transparant, Centre for Psychiatry, Leiden, The Netherlands.; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands., de Rotte MC; SCAL Medical Diagnostics, Leiden, The Netherlands., Souverein PC; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands., Herings RM; PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands.; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, Netherlands., Heerdink ER; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.; Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands.; Research Group Innovation of Pharmaceutical Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands. |
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Jazyk: | angličtina |
Zdroj: | Bipolar disorders [Bipolar Disord] 2019 Aug; Vol. 21 (5), pp. 419-427. Date of Electronic Publication: 2019 Jan 02. |
DOI: | 10.1111/bdi.12730 |
Abstrakt: | Objectives: Laboratory monitoring of patients using lithium is important to prevent harm and to increase effectiveness. The aim of this study is to determine compliance with the guidelines for laboratory monitoring of patients treated with lithium overall and within subgroups. Methods: Patients having at least one lithium dispensing for 6 months or longer between January 2010 and December 2015 were identified retrospectively using data from the Dutch PHARMO Database Network. Laboratory monitoring was defined as being compliant with the Dutch Multidisciplinary Clinical Guideline Bipolar Disorders when lithium serum levels, creatinine and thyroid-stimulating hormone (TSH) had been measured at least every 6 months during lithium use. Results: Data were analyzed from 1583 patients with a median duration of 7- to 6-months period of lithium use. Results indicated that patients had been monitored over 6-month period for lithium serum levels 65% of the time, for creatinine 73% of the time and for TSH 54% of the time. Just over one seventh (16%) of patients had been monitored in compliance with the guidelines for all three parameters during total follow-up. Especially males, patients aged below 65 years, patients receiving prescriptions solely from general practitioners, prevalent users of lithium, patients without interacting co-medication, and patients without other days with laboratory measurements had been monitored less frequently in compliance with the guidelines. Conclusions: A considerable proportion of patients had not been monitored in accordance with the guidelines. Further research is needed to understand the reasons for noncompliance and to implement strategies with the ultimate goal of optimizing safety and effectiveness for patients treated with lithium. (© 2018 The Authors. Bipolar Disorders Published by John Wiley & Sons Ltd.) |
Databáze: | MEDLINE |
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