患者是否遵守12小时锂血药浓度定时?来自对照临床试验和真实世界临床环境的研究结果。

IF 4.5 2区 医学 Q1 CLINICAL NEUROLOGY
Søren L Jacobsen, Christian L Kraft, Andrew A Nierenberg, Torben A Devantier, Ole Köhler-Forsberg
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引用次数: 0

摘要

背景:锂给药后12小时常规测量血锂水平,但没有研究评估患者对12小时水平的实际依从性。方法:首先,我们使用了美国多中心临床试验“双相选择”(n = 145名接受锂治疗的患者进行了n = 287次锂血液测试),参与者报告了从最后一次锂剂量到锂血液测试的时间。其次,我们纳入了2012-2022年期间来自丹麦中部地区(CDR,约130万人口)的医院和私人医生的所有锂血液测试(3179人,52,837次血液测试),包括锂血液测试的时间和患者应该服用锂剂量的登记时间。结果:在双相选择中,参与者在锂给药后平均/中位数为12.8/12 h (SD = 9.1, IQR = 10.5-14),但范围为0.5-120 h, 44.9%的参与者在锂给药后14 h进行了血液检查。锂剂量14小时后血液测试>的患者锂水平显著降低(0.41比0.64)。在CDR中,平均/中位时间为14.5/13.7 (SD = 3.8, IQR = 12.0-15.8), 49.7%的患者在假定摄入锂后14小时进行了血液检查。那些在锂摄入和锂血液测试之间bbb16小时的人更常被全科医生跟踪,显示出较高的肌酐浓度。结论:大约一半的锂血液测试不符合基于指南的12小时低谷水平建议,强调需要解决这一临床需求的解决方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Do Patients Comply With 12-h Lithium Blood Level Timing? Findings From a Controlled Clinical Trial and a Real-World Clinical Setting.

Background: Lithium blood levels are measured routinely 12 h after lithium dosing, but no study has evaluated the actual compliance of patients with the 12-h levels.

Methods: First, we used the US multicenter clinical trial "Bipolar CHOICE" (n = 145 patients treated with lithium with N = 287 lithium blood tests), where participants reported the time since the last lithium dose at lithium blood tests. Second, we included all lithium blood tests (3179 individuals, 52,837 blood tests) from hospitals and private practitioners in the Central Denmark Region (CDR, approximate population 1.3 million) during 2012-2022, including the time of lithium blood tests and the registered time when patients were supposed to take their lithium dose.

Results: In Bipolar CHOICE, participants took the lithium blood test at a mean/median of 12.8/12 h (SD = 9.1, IQR = 10.5-14) after the lithium dose, but the range was 0.5-120 h and 44.9% had the blood test taken < 10 or > 14 h after the lithium dose. Those with a blood test > 14 h after the lithium dose had significantly lower lithium levels (0.41 vs. 0.64). In the CDR, the mean/median time was 14.5/13.7 (SD = 3.8, IQR = 12.0-15.8) and 49.7% had the blood test taken < 10 or > 14 h after the supposed intake of lithium. Those with > 16 h between lithium intake and the lithium blood test were more often followed by general practitioners and showed higher creatinine concentrations.

Conclusions: Approximately half of lithium blood tests do not comply with guideline-based recommendations for 12-h trough levels, emphasizing the need for solutions to solve this clinical need.

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来源期刊
Bipolar Disorders
Bipolar Disorders 医学-精神病学
CiteScore
8.20
自引率
7.40%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Bipolar Disorders is an international journal that publishes all research of relevance for the basic mechanisms, clinical aspects, or treatment of bipolar disorders and related illnesses. It intends to provide a single international outlet for new research in this area and covers research in the following areas: biochemistry physiology neuropsychopharmacology neuroanatomy neuropathology genetics brain imaging epidemiology phenomenology clinical aspects and therapeutics of bipolar disorders Bipolar Disorders also contains papers that form the development of new therapeutic strategies for these disorders as well as papers on the topics of schizoaffective disorders, and depressive disorders as these can be cyclic disorders with areas of overlap with bipolar disorders. The journal will consider for publication submissions within the domain of: Perspectives, Research Articles, Correspondence, Clinical Corner, and Reflections. Within these there are a number of types of articles: invited editorials, debates, review articles, original articles, commentaries, letters to the editors, clinical conundrums, clinical curiosities, clinical care, and musings.
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