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  • Bosi, A.Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (author)

Quality of laboratory biomarker monitoring during treatment with lithium in patients with bipolar disorder

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • 2023-02
  • Wiley,2023

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/324633
  • https://gup.ub.gu.se/publication/324633URI
  • https://doi.org/10.1111/bdi.13302DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-204757URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:151814003URI

Supplementary language notes

  • Language:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • BackgroundClinical guidelines recommend monitoring of creatinine and lithium throughout treatment with lithium. We here assessed the extent to which this occurs in healthcare in Sweden. MethodsThis is an observational study of all adults with bipolar disorder starting lithium therapy in Stockholm, Sweden, during 2007-2018. The main outcome was monitoring of blood lithium and creatinine at therapy initiation and/or once annually. The secondary outcome was monitoring of calcium and thyroid-stimulating hormone (TSH). Patients were followed up until therapy cessation, death, out-migration, or to the end of 2018. ResultsWe identified 4428 adults with bipolar disorder who started lithium therapy and were followed up for up to 11 years. Their median age was 39 years, and 63% were women. The median duration on lithium therapy was 4.3 (IQR: 1.9-7.45) years, and the majority who discontinued therapy started another mood stabilizer soon after. Overall, 21% started lithium therapy without assessing the serum/plasma concentration of creatinine. The proportion of people who did not have both lithium and creatinine measured increased from 21% in the first year to 33% in the eleventh year. The proportion with annual testing for TSH or calcium was slightly lower. As few as 16% of patients had both lithium and creatinine tested once annually during their complete time on lithium. ConclusionsIn a Swedish community sample, lithium and creatinine monitoring was inconsistent with guideline recommendations that call for measurement of annual biomarker levels.

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  • Ceriani, L.Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; University of Milano-Bicocca, Milan, Italy (author)
  • Elinder, C. G.Renal Medicine, CLINTEC, Karolinska Institutet, Stockholm, Sweden (author)
  • Bellocco, R.Karolinska Institutet (author)
  • Clase, C. M.Department of Medicine and Health Research Methods, Evidence and Impact, McMaster University, ON, Hamilton, Canada (author)
  • Landén, Mikael,1966Karolinska Institutet,Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Neuroscience and Physiology, Gothenburg University, Gothenburg, Sweden(Swepub:gu)xlandt (author)
  • Carrero, J. J.Karolinska Institutet (author)
  • Runesson, BjörnUmeå universitet,Institutionen för folkhälsa och klinisk medicin(Swepub:umu)bjru0001 (author)
  • Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, SwedenDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; University of Milano-Bicocca, Milan, Italy (creator_code:org_t)

Related titles

  • In:Bipolar Disorders: Wiley25:6, s. 499-5061398-56471399-5618

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