Chen Yifeng, Zhang Jian, Hou Fengsu, Bai Yuanhan
Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, People's Republic of China.
Patient Prefer Adherence. 2022 Nov 2;16:2989-2999. doi: 10.2147/PPA.S384683. eCollection 2022.
Lithium has been widely used to treat bipolar disorder (BD), although its adherence is rarely reported in China. This study aimed to explore the rate of lithium adherence and its associated factors in patients with BD, which has rarely been reported in China.
We conducted a cross-sectional study among patients in Shenzhen Mental Health Center (Shenzhen Kangning Hospital), who were aged 12 years or above, were diagnosed with BD based on the International Classification of Diseases, tenth edition (ICD-10), and had been on lithium for at least 1 month. We collected information on sociodemographic and clinical characteristics and on knowledge about and attitudes toward lithium. We also investigated patients' concerns while taking lithium and where they can and wish to obtain information on lithium.
Of the 244 enrolled patients and 221 patients aged 18 years or older, 52% and 50% disclosed low adherence to lithium, respectively. Factors associated with poor lithium adherence were a younger age (odds ratio (OR): 0.962, 95% confidence interval (CI): 0.933-0.992), female sex (OR: 2.171, 95% CI: 1.146-4.112), and no hospitalization history (OR: 0.389, 95% CI: 0.217-0.689) for the full sample, and more years of education (OR: 4.086, 95% CI: 1.397-11.946) and fewer hospitalizations (OR: 0.615, 95% CI: 0.467-0.809) for patients aged 18 years or older. Less knowledge of periodic tests conducted during lithium treatment played a critical role in low lithium adherence (regression analysis of the full sample: OR: 0.642, 95% CI: 0.532-0.775, regression analysis of subgroups: OR: 0.609, 95% CI: 0.500-0.742). The treatment duration was a major concern among patients on lithium, and patients preferred obtaining lithium-associated information through health services and WeChat.
The rate of lithium adherence was low in this study. Psychoeducation to increase lithium compliance should mainly focus on patients who are young and provide thorough background information on lithium. Health services should actively provide lithium-associated information. A greater need for medication information based on WeChat was observed, implying its potential role in adherence-related psychoeducation.
锂盐已被广泛用于治疗双相情感障碍（BD），尽管在中国其依从性鲜有报道。本研究旨在探讨BD患者中锂盐的依从率及其相关因素，这在中国鲜有报道。
我们在深圳市精神卫生中心（深圳市康宁医院）对年龄在12岁及以上、根据国际疾病分类第十版（ICD - 10）被诊断为BD且服用锂盐至少1个月的患者进行了一项横断面研究。我们收集了社会人口学和临床特征以及关于锂盐的知识和态度方面的信息。我们还调查了患者服用锂盐时的担忧以及他们能够且希望从何处获取锂盐相关信息。
在244名入组患者和221名18岁及以上患者中，分别有52%和50%的患者表示锂盐依从性低。与锂盐依从性差相关的因素在全样本中为年龄较小（比值比（OR）：0.962，95%置信区间（CI）：0.933 - 0.992）、女性（OR：2.171，95% CI：1.146 - 4.112）和无住院史（OR：0.389，95% CI：0.217 - 0.689），在18岁及以上患者中为受教育年限更多（OR：4.086，95% CI：1.397 - 11.946）和住院次数更少（OR：0.615，95% CI：0.467 - 0.809）。对锂盐治疗期间进行的定期检查了解较少在低锂盐依从性中起关键作用（全样本回归分析：OR：0.642，95% CI：0.532 - 0.775，亚组回归分析：OR：0.609，95% CI：0.500 - 0.742）。治疗持续时间是服用锂盐患者的主要担忧，患者更倾向于通过医疗服务和微信获取锂盐相关信息。
本研究中锂盐的依从率较低。提高锂盐依从性的心理教育应主要针对年轻患者，并提供关于锂盐的全面背景信息。医疗服务应积极提供锂盐相关信息。观察到对基于微信的用药信息有更大需求，这意味着其在依从性相关心理教育中的潜在作用。
