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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Standards of lithium monitoring in mental health trusts in the UK | Collins et al. BMC Psychiatry 2010 10 80 http www.biomedcentral.com 1471-244X 10 80 BMC Psychiatry RESEARCH ARTICLE Open Access Standards of lithium monitoring in mental health trusts in the UK 1.2 23 2 4 2 3 Noel Collins 1 Thomas RE Barnes Amber Shingleton-Smith David Gerrett Carol Paton Abstract Background Lithium is a commonly prescribed drug with a narrow therapeutic index and recognised adverse effects on the kidneys and thyroid. Clinical guidelines for the management of bipolar affective disorder published by The National Institute for Health and Clinical Excellence NICE recommend checks of renal and thyroid function before lithium is prescribed. They further recommend that all patients who are prescribed lithium should have their renal and thyroid function checked every six months and their serum lithium checked every three months. Adherence to these recommendations has not been subject to national UK audit. Methods The Prescribing Observatory for Mental Health POMH-UK invited all National Health Service Mental Health Trusts in the UK to participate in a benchmarking audit of lithium monitoring against recommended standards. Data were collected retrospectively from clinical records and submitted electronically. Results 436 clinical teams from 38 Trusts submitted data for 3 373 patients. In patients recently starting lithium there was a documented baseline measure of renal or thyroid function in 84 and 82 respectively. For patients prescribed lithium for a year or more the NICE standards for monitoring lithium serum levels and renal and thyroid function were met in 30 55 and 50 of cases respectively. Conclusions The quality of lithium monitoring in patients who are in contact with mental health services falls short of recognised standards and targets. Findings from this audit along with reports of harm received by the National Patient Safety Agency prompted a Patient Safety Alert mandating primary care mental health and acute Trusts and laboratory staff to .
