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Abstract |
| Title |
: =The Evaluation of Lithium Follow up Approach in Psychiatric |
| By |
: ThamonwanNantha and ThummaritSindhusakul |
| Degree |
: DOCTOR OF PHARMACY |
| Advisor |
: Asst.Prof.NonglekKunawaradisai, Ph.D. and Asst.Prof.Sawaeng Watcharathanakij,Ph.D. |
| Keywords |
: moodstabilizer, lithium |
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| Lithium is one of mood stabilizing agents which are classified as high alertdrug with narrow therapeutic index and many adverse events. In order to obtain therapeutic effect, an approach for follow up andlaboratory monitoring of lithium in each institution was established in patients using this medication. Objective= To evaluate the appropriateness for lithium follow up and laboratory monitoring following to the hospital’s guideline. The objective also includes the correlation between lithium plasma level and its clinical effect. Materials andMethods= This study was retrospective and the data were collected from out-patient-department card together with computerized data base ofPrasrimahabhodi Psychiatric Hospital during August - November 2015. The subjects were out patients who were prescribed lithium during 2013 - 2014. The data were collected using patient collecting data sheet together with an evaluation form for following up and laboratory monitoring of lithium according to guideline developed from Prasrimahabhodi Psychiatric Hospital in 2012. Results= There are 256 patients recruited into the study. According to the hospital’s guideline, patients prescribedwith lithium were divided into four groups. The first group of 38 patients must have been examined before prescribing lithium. Of those, there were 12 subjects (31.6%) who were laboratorial examined. The second group of 61 patients who were taking lithium must have been tested for their serum lithium level after taking this medication for 7 days. The results revealed that none of these were received any blood test for lithium level. The third groups of 44 subjects were patients prescribing lithium continuously for 1 year and there only 8 patients (18.2%) received the laboratory test according to hospital’s guideline.The last group of 204 subjects treated with lithium more than one year showed 80 patients (39.2%) who were completed the follow up and laboratory tests. In terms of lithium plasma level, the results indicated that most patients have serum lithium level as subtherapeutic and therapeutic level with good clinical symptoms more than 60%. Conclusion= The results from this study indicated that patients follow up and laboratory assessment in patients treated with lithium was not completed according to the guideline regulations. Therefore, an approach to promote or motive this scheme is needed in order to increase the safety and efficacy use of lithium.
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