Monitoring of patients treated with lithium for bipolar disorder: an international survey
Abstract Background Adequate monitoring of patients using lithium is needed for optimal dosing and for early identification of patients with (potential) ADEs. The objective was to internationally assess how health care professionals monitor patients treated with lithium for bipolar disorder. Methods...
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doaj-f78dee17f33f433796785181afee30ce2020-11-25T00:14:20ZengSpringerOpenInternational Journal of Bipolar Disorders2194-75112018-04-01611910.1186/s40345-018-0120-1Monitoring of patients treated with lithium for bipolar disorder: an international surveyM. Nederlof0E. R. Heerdink1A. C. G. Egberts2I. Wilting3L. J. Stoker4R. Hoekstra5R. W. Kupka6Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht UniversityDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht UniversityDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht UniversityDepartment of Clinical Pharmacy, University Medical Center UtrechtDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht UniversityAntes, Delta Psychiatric CenterDepartment of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical CenterAbstract Background Adequate monitoring of patients using lithium is needed for optimal dosing and for early identification of patients with (potential) ADEs. The objective was to internationally assess how health care professionals monitor patients treated with lithium for bipolar disorder. Methods Using networks of various professional organizations, an anonymous online survey was conducted among health care professionals prescribing lithium. Target lithium serum levels and frequency of monitoring was assessed together with monitoring of physical and laboratory parameters. Reasons to and not to monitor and use of guidelines and institutional protocols, and local monitoring systems were investigated. Results The survey was completed by 117 health care professionals incorporating responses from twenty-four countries. All prescribers reported to monitor lithium serum levels on a regular basis, with varying target ranges. Almost all (> 97%) monitored thyroid and renal function before start and during maintenance treatment. Reported monitoring of other laboratory and physical parameters was variable. The majority of respondents (74%) used guidelines or institutional protocols for monitoring. In general, the prescriber was responsible for monitoring, had to request every monitoring parameter separately and only a minority of patients was automatically invited. Conclusions Lithium serum levels, renal and thyroid function were monitored by (almost) all physicians. However, there was considerable variation in other monitoring parameters. Our results help to understand why prescribers of lithium monitor patients and what their main reasons are not to monitor patients using lithium.http://link.springer.com/article/10.1186/s40345-018-0120-1LithiumBipolar disorderSurveyMonitoringTherapeutic drug monitoring |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
M. Nederlof E. R. Heerdink A. C. G. Egberts I. Wilting L. J. Stoker R. Hoekstra R. W. Kupka |
spellingShingle |
M. Nederlof E. R. Heerdink A. C. G. Egberts I. Wilting L. J. Stoker R. Hoekstra R. W. Kupka Monitoring of patients treated with lithium for bipolar disorder: an international survey International Journal of Bipolar Disorders Lithium Bipolar disorder Survey Monitoring Therapeutic drug monitoring |
author_facet |
M. Nederlof E. R. Heerdink A. C. G. Egberts I. Wilting L. J. Stoker R. Hoekstra R. W. Kupka |
author_sort |
M. Nederlof |
title |
Monitoring of patients treated with lithium for bipolar disorder: an international survey |
title_short |
Monitoring of patients treated with lithium for bipolar disorder: an international survey |
title_full |
Monitoring of patients treated with lithium for bipolar disorder: an international survey |
title_fullStr |
Monitoring of patients treated with lithium for bipolar disorder: an international survey |
title_full_unstemmed |
Monitoring of patients treated with lithium for bipolar disorder: an international survey |
title_sort |
monitoring of patients treated with lithium for bipolar disorder: an international survey |
publisher |
SpringerOpen |
series |
International Journal of Bipolar Disorders |
issn |
2194-7511 |
publishDate |
2018-04-01 |
description |
Abstract Background Adequate monitoring of patients using lithium is needed for optimal dosing and for early identification of patients with (potential) ADEs. The objective was to internationally assess how health care professionals monitor patients treated with lithium for bipolar disorder. Methods Using networks of various professional organizations, an anonymous online survey was conducted among health care professionals prescribing lithium. Target lithium serum levels and frequency of monitoring was assessed together with monitoring of physical and laboratory parameters. Reasons to and not to monitor and use of guidelines and institutional protocols, and local monitoring systems were investigated. Results The survey was completed by 117 health care professionals incorporating responses from twenty-four countries. All prescribers reported to monitor lithium serum levels on a regular basis, with varying target ranges. Almost all (> 97%) monitored thyroid and renal function before start and during maintenance treatment. Reported monitoring of other laboratory and physical parameters was variable. The majority of respondents (74%) used guidelines or institutional protocols for monitoring. In general, the prescriber was responsible for monitoring, had to request every monitoring parameter separately and only a minority of patients was automatically invited. Conclusions Lithium serum levels, renal and thyroid function were monitored by (almost) all physicians. However, there was considerable variation in other monitoring parameters. Our results help to understand why prescribers of lithium monitor patients and what their main reasons are not to monitor patients using lithium. |
topic |
Lithium Bipolar disorder Survey Monitoring Therapeutic drug monitoring |
url |
http://link.springer.com/article/10.1186/s40345-018-0120-1 |
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