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Compliance with the safety guidelines for long-term lithium treatment in Sweden

Artikel i vetenskaplig tidskrift
Författare M. Golic
Harald Aiff
Per-Ola Attman
B. Ramsauer
S. Schon
Jan Svedlund
Publicerad i Journal of Psychopharmacology
Volym 32
Nummer/häfte 10
Sidor 1104-1109
ISSN 0269-8811
Publiceringsår 2018
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi
Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Sidor 1104-1109
Språk en
Länkar dx.doi.org/10.1177/0269881118780014
Ämnesord Lithium, creatinine, guidelines, compliance, gender, disorders, therapy, bipolar, uk, Neurosciences & Neurology, Pharmacology & Pharmacy, Psychiatry
Ämneskategorier Neurovetenskaper, Farmakologi

Sammanfattning

Background: Lithium has been used for more than 50 years and guidelines for treatment monitoring have been documented in Sweden since the beginning of the 1980s. Aims: The aim of this study was to describe compliance over time with the Swedish guidelines for long-term lithium treatment. Methods: The study material was obtained from Sahlgrenska University Hospital's laboratory database. We analysed data (serum lithium and serum creatinine) of adult patients treated with lithium between 1981 and 2010, and determined compliance with guidelines and serum lithium levels over time. Results: Our study material included 2841 patients and 25,300 treatment-years. The compliance with guidelines' recommendations regarding lithium and creatinine monitoring increased from 36% in 1981 to 68% in 2010. Women were on average 2% more compliant than men (p < 0.01). Most lithium samples (87-94%) were within recommended intervals throughout the study period. The average lithium level decreased from 0.70 mmol/L in 1981 to 0.58 mmol/L in 2001, and remained stable thereafter. Conclusions: Compliance with lithium monitoring guidelines improved slowly but steadily over time. It took three decades to reach a compliance rate of just below 70%. Gender differences were small, but with a significantly better compliance rate for women. Serum lithium was kept within the recommended target interval to a large extent, throughout the study period.

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