Impact of active monitoring on lithium management in Norfolk
Impact of active monitoring on lithium management in Norfolk
复制标题
DOI：
10.1177/2045125313486510
复制
发表时间：
2013-10-01
影响因子：
4.2
通讯作者：
Desborough, James A.
中科院分区：
文献类型：
--
作者：
Kirkham, Emma;Bazire, Stephen;Desborough, James A.
背景：自19世纪以来，锂一直被用于风湿病和精神病学领域，现在被普遍认为是治疗双相情感障碍的黄金标准。然而，锂已知有显著的副作用，需要密切的血清水平监测，以确保水平保持在治疗范围内，将严重不良反应或毒性的风险降至最低。本文回顾了锂的监测以及关于诺福克地区锂登记和数据库实施情况的报告。方法：从诺福克锂数据库中提取记录的血液结果，从整个地区的第一个全年，2005/6，和最近的2011/12全年。锂监测试验的次数，结果：在2005/6年度，有相当数量的人没有接受推荐的每年四次或四次以上的血清锂检测(68.3%)，大多数人进行了两次或三次检测(62%)。到2011/12年度，这一数字明显增加，大多数患者每年进行四次或更多检查(68.5%)，而只进行两到三次检查的患者数量大幅减少(26.4%)。结论：自引入诺福克数据库以来，锂检测和监测率有所提高，有助于实现国家目标。因此，由于监测不足而发生不良事件的可能性已降至最低。
Background: Lithium has been used in the fields of rheumatology and psychiatry since the 1800s and it is now generally considered to be a gold standard treatment for bipolar disorders. However, lithium is known to have significant side effects and requires close serum level monitoring to ensure levels remain within the therapeutic range to minimize the risk of serious adverse effects or toxicity. This article reviews the monitoring of lithium and reports on the implementation of a regional lithium register and database within Norfolk.Methods: Recorded blood results from the Norfolk lithium database were extracted for the first full year of operation across the region, 2005/6, and from the most recent full year 2011/12. The number of lithium monitoring tests, U&Es and thyroid function tests conducted on all people registered on the database were compared between the two sample years.Results: In 2005/6 there were a significant number of people not receiving the recommended number of four or more serum lithium test per year (68.3%) and the majority of people had two or three tests (62%). By 2011/12 this had noticeably increased with the majority of patients having four or more tests per year (68.5%) and the number having only two or three tests reducing dramatically (26.4%).Conclusion: Improved rates of lithium testing and monitoring have been demonstrated since the introduction of the Norfolk database helping to achieve national targets. Consequently, the chances of adverse events from insufficient monitoring have been minimized.