นโยบายงานวิจัย /จรรยาบรรณนักวิจัย /ระดับคุณภาพบทความวิจัยตีพิมพ์ /ระดับคุณภาพผลงานวิชาการ /แหล่งทุน /ดาวน์โหลด /ฐานข้อมูลวิจัย /วิเคราะห์-สังเคราะห์งานวิจัย /ลิขสิทธิ์ /ข่าว


การประเมินการตรวจติดตามการใช้ยาลิเทียมในผู้ป่วยจิตเวช โรงพยาบาลพระศรีมหาโพธิ์


Author

-

น้องเล็ก คุณวราดิศัย, แสวง วัชระธนกิจ, วีระ ตุลย์ชุประภา, ธมลวรรณ นันทา, ธรรมฤทธิ์ สินธุสกุล


Journal

- วารสารเภสัชกรรมโรงพยาบาล

Volume

- 26

Year

- 2559

Publication type

- Research article (National)

Page list

- 9-19

Abstract

   

Background: Lithium is a mood stabilizing agent and has narrow therapeutic index. The drug frequently causes adverse events. In order to obtain therapeutic effect, an approach for a close monitoring of lithium use in psychiatric patients was established.
Objectives: To evaluate the lithium plasma level monitoring, laboratory test and special examination in patients receiving lithium treatment in terms of the adherence to the hospital monitoring guideline and the lithium plasma level outcomes. The correlation between lithium plasma level and its clinical outcomes was also determined.
Method: This study was retrospective and the data were collected from computerized database of Prasrimahabhodi Psychiatric Hospital together with out-patient-department card. Patients treated with lithium during 2013-2014 in an outpatient department were included. Evaluating the lithium plasma level monitoring, laboratory test and special examination in patients receiving lithium treatment according to the hospital monitoring
guideline adopted in 2012. The data were collected and analysed with descriptive statistics. There were 256 patients recruited into the study.
Results: According to the hospital guideline, patients prescribed with lithium were divided into 4 groups. The first group (38 patients) must have been examined before lithium was prescribed. Of these, there were 12 subjects (31.6%) who were examined. The second group (61 patients) who were taking lithium must have been checked for their lithium plasma level after taking lithium for 7 days. None of these 61 patients were checked for lithium plasma level. The third group (44 subjects) were patients who were prescribed with lithium continuously during the first year of treatment. There were only 8 patients (18.2%) of the third group who were checked for lithium plasma level and special examination according to hospital guideline. The last group of 204  subjects treated with lithium more than one year showed 80 patients (39.2%) who completed the follow up and laboratory tests. In terms of lithium plasma level, the results indicated that there were 80 (31.3%) and 2 patients (0.8%) with sub-therapeutic and over-therapeutic lithium level, respectively. Moreover, 91 incidences of adverse drug reactions were reported.
Conclusion: The results indicated that the adherence to the hospital guideline for the lithium plasma level monitoring, laboratory test and special examination in patients receiving lithium treatment, adopted in 2012, were not fully followed. Therefore, an approach to promote or motivate this scheme is needed in order to increase the safety and efficacy of lithium use in patients.


Keywords

   

mood stabilizer, lithium