尼日利亚双相情感障碍患者锂盐处方面临的挑战。

Challenges of lithium prescription in bipolar disorders in Nigeria.

作者信息

Adiukwu Frances Nkechi, Salihu Mumeen Olaitan, Hayatudeen Nafisatu, Kareem Yesiru Adeyemi, Adegoke Benjamin Olamide, Charles-Ugwuagbo Ijeoma Chinanuekperem, Uwah Emmanuel Effiong, Adesina Ismail Olaiitan, Ibrahim Abba Mohammed, Fugu Muhammad Abba

机构信息

Department of Mental Health, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria.

Department of Behavioural Sciences, Kwara State University Teaching Hospital, Ilorin, Kwara State, Nigeria.

出版信息

BMC Psychiatry. 2025 Mar 31;25(1):304. doi: 10.1186/s12888-025-06736-0.

DOI:10.1186/s12888-025-06736-0

PMID:40165174

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11956461/

Abstract

BACKGROUND

Lithium prescription rates have witnessed a significant downward trend over the years in different continents despite evidence of its clinical efficacy in the acute and long-term maintenance treatment of Bipolar Disorder (BD). Nigeria has a paucity of data on lithium use in BD management. Hence, we aim to investigate the lithium prescription rate and factors influencing its use among Nigerian psychiatrists and trainee psychiatrists.

METHODS

A cross-sectional survey involving 203 respondents working in different accredited psychiatric training facilities in Nigeria was conducted between April and May 2024 using a predesigned online Google form. Information relating to lithium use in managing the different phases of BD and factors influencing its use were assessed.

RESULTS

The mean age of the respondents was 37.98 (± 6.85) years. The lithium prescription rate is low (10.89%). There is a significant association between the respondents' awareness of clinical practice guidelines (CPG) and good adherence to CPG (p = 0.003), but this did not significantly influence lithium prescription among them. Older years of practice influence prescribing lithium (p = < 0.001). Monitoring and availability of lithium constituted significant concerns for lithium use, among other factors (p = 0.032).

CONCLUSION

The study revealed a low lithium prescription rate among Nigerian psychiatrists and trainee psychiatrists compared to international studies. There is a need for concerted efforts towards addressing the identified factors. A review of the existing local CPG in line with the best evidence is warranted for improved clinical outcomes.

ETHICS REGISTRATION

The study was approved by the Hospital Research and Ethical Committee (HREC) of the University of Port Harcourt Teaching Hospital (UPTH) with approval protocol number (UPTH/ADM/90/S.11/VOL.XI/1688).

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

尽管有证据表明锂盐在双相情感障碍（BD）的急性和长期维持治疗中具有临床疗效，但多年来不同大陆的锂盐处方率呈显著下降趋势。尼日利亚缺乏关于锂盐用于BD管理的数据。因此，我们旨在调查尼日利亚精神科医生和精神科实习医生的锂盐处方率及其使用的影响因素。

方法

2024年4月至5月间，使用预先设计的在线谷歌表单对尼日利亚不同认可的精神科培训机构工作的203名受访者进行了横断面调查。评估了与锂盐用于管理BD不同阶段以及影响其使用的因素相关的信息。

结果

受访者的平均年龄为37.98（±6.85）岁。锂盐处方率较低（10.89%）。受访者对临床实践指南（CPG）的知晓与对CPG的良好依从性之间存在显著关联（p = 0.003），但这并未显著影响他们的锂盐处方情况。较长的从业年限会影响锂盐处方（p = <0.001）。除其他因素外，锂盐的监测和可获得性是锂盐使用的重要关注点（p = 0.032）。