Department of Psychiatry, Queen's University, Kingston, ON, Canada; Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Office of Professional Development and Educational Scholarship, Queen's University, Kingston, ON, Canada.
J Psychiatr Res. 2023 Aug;164:335-343. doi: 10.1016/j.jpsychires.2023.06.005. Epub 2023 Jun 26.
Lithium remains the gold-standard medication for acute and prophylactic treatment of bipolar disorder. Understanding clinicians' practices and patients' experiences, knowledge and attitudes about lithium may improve its clinical use.
Online anonymous surveys collected information about clinician's practices and level of confidence in managing lithium and patients' experiences with lithium treatment and information received about benefits and side effects. Knowledge and attitudes regarding lithium were assessed with the Lithium Knowledge Test (LKT) and the Lithium Attitudes Questionnaire (LAQ).
Among 201 clinicians, 64.2% endorsed often treating patients with lithium and reported high levels of confidence in assessing and managing lithium. Practices concerning clinical indications, drug titration, and serum levels were guideline-concordant, but compliance with monitoring recommendations was less frequent. Practitioners were interested in receiving more education about lithium. The patients' survey recruited 219 participants with 70.3% being current lithium users. Most patients (68%) found lithium helpful and 71% reported experiencing any kind of side effect. Most responders did not receive information about side effects or other benefits of lithium. Patients with higher scores on the LKT were more likely to have positive attitudes about lithium.
Cross-sectional design with predominantly English-speaking participants from Brazil and North America.
There is a discrepancy between guidelines, clinician confidence and knowledge of lithium use and practice. A deeper understanding of how to monitor, prevent and manage long-term side effects and which patients are most likely to benefit from lithium may narrow the gap between knowledge and use.
锂仍是双相情感障碍急性和预防性治疗的金标准药物。了解临床医生的实践以及患者对锂的经验、知识和态度，可能会改善其临床应用。
在线匿名调查收集了有关临床医生管理锂的实践和信心水平以及患者锂治疗经验和有关益处和副作用信息的信息。使用锂知识测试（LKT）和锂态度问卷（LAQ）评估了锂相关知识和态度。
在 201 名临床医生中，64.2%的人经常为患者开具锂盐处方，并对评估和管理锂盐具有高度信心。关于临床适应症、药物滴定和血清水平的实践与指南一致，但对监测建议的依从性较低。从业者有兴趣接受更多关于锂的教育。患者调查共招募了 219 名参与者，其中 70.3%为当前锂盐使用者。大多数患者（68%）认为锂盐有帮助，71%的患者报告出现任何类型的副作用。大多数患者未收到有关锂盐副作用或其他益处的信息。LKT 得分较高的患者对锂盐的态度更为积极。
这是一项横断面研究，参与者主要来自巴西和北美讲英语的人群。
指南、临床医生对锂使用的信心和知识与实践之间存在差距。更深入地了解如何监测、预防和管理长期副作用以及哪些患者最有可能从锂盐中获益，可能会缩小知识与应用之间的差距。
