Monitoramento da adesão ao tratamento com lítio

Rosa, Adriane Ribeiro; Kapczinski, Flávio; Oliva, Renata; Stein, Airton Tetelbom; Barros, Helena Maria Tannhauser

doi:10.1590/s0101-60832006000500005

Cited by 26 publications

(43 citation statements)

References 22 publications

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“…Therefore, the level of knowledge concerning the therapeutic framework and the lithium is related to better adherence and lower toxicity risk (5) .…”

Section: Discussionmentioning

confidence: 99%

“…Thus, adherence to medication is essential for people with BD to respond satisfactorily to the treatment (3)(4) . Several factors, however, contribute to the poor adherence to medication, being the lack of knowledge about the medications an important factor (5)(6) . Therefore, the level of patients' knowledge should be identified in planning nursing actions aimed at optimizing the treatment (7) .…”

Section: Introductionmentioning

confidence: 99%

“…It can be highlighted that the BD treatment has a broad range of therapeutic resources but the "gold standard" medication for the treatment of this disorder is lithium carbonate (3,5,(9)(10) . Although effective, this substance requires specific care as it has a narrow therapeutic range, high risk of intoxication (9)(10)(11)(12) and slow onset of action, is subject to serum variation levels due to pharmacological interactions, and presents elimination and dosage-plasma level variations among people (7) .…”

Section: Introductionmentioning

confidence: 99%

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Bipolar disorder and medication: adherence, patients' knowledge and serum monitoring of lithium carbonate

Souza

Vedana

Mercedes

et al. 2013

Rev. Latino-Am. Enfermagem

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Objectives: this study featured patients with affective bipolar disorder who were making use of lithium and received care at an outpatient care center located in a country town in the state of Sao Paulo in 2009; it assessed the adherence and knowledge of these patients in relation to the medication prescribed to them and verified the proportion of blood tests performed per year in the service, for each individual, to measure lithium levels in the blood. Method: descriptive study with quantitative approach, involving 36 participants. Structured interviews and review of medical records were used for data collection and descriptive statistics for data analysis. Results: difficulties in reporting the dosage of the medication prescribed and a high rate of non-adherence were identified among the participants. None of the participants in the study was submitted to two tests a year to measure lithium levels in the blood, which is the minimum proportion of tests recommended by the literature for maintenance treatment using lithium carbonate. Conclusion: this study highlights the critical factors for the promotion of patients' safety in monitoring lithium drug therapy.

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“…Therefore, the level of knowledge concerning the therapeutic framework and the lithium is related to better adherence and lower toxicity risk (5) .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bipolar disorder and medication: adherence, patients' knowledge and serum monitoring of lithium carbonate

Souza

Vedana

Mercedes

et al. 2013

Rev. Latino-Am. Enfermagem

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“…The use of lithium (Li) is the most effective long-term therapy for affective disorders, such as bipolar affective disorder (BAD), as it protects users against humor fluctuations reducing manic and depressive phases in this illness and, consequently, reduces mortality and the risk of suicide (3)(4)(5). Despite recent advances in pharmacological treatment of psychiatric disorders in Brazil, Li remains as an effective and low cost alternative drug, being provided free of charges by the National Health System in the form of Lithium Carbonate (LC) (6,7).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of parathyroid function and mineral metabolism in psychiatric patients using lithium salts

Oliveira

Neto

Aguiar‐Oliveira

et al. 2014

Arq Bras Endocrinol Metab

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Objective: To evaluate parathyroid function and mineral metabolism in psychiatric patients users of lithium salts. Materials and methods: We measured the serum levels of calcium, ionized calcium, inorganic phosphorus, alkaline phosphatase, albumin, parathyroid hormone (PTH), urea, creatinine, 25-hydroxy-vitamin D and lithium of 35 patients diagnosed with bipolar disorder in use of lithium carbonate (LC) for at least one year (Lithium Group -LG) and 35 healthy subjects (Control Group -CG). Results: The LG and CG were matched by sex and age. There was only statistic difference in relation to the levels of PTH and ionized calcium, with p < 0.004 and p < 0.03, respectively. Secondary form of hyperparathyroidism (HPT) was found in eight (22.8%) LG patients and in none of the CG. There was no correlation between lithemia, usage time and dosage of LC. Conclusion: Our data demonstrate that lithium may create an imbalance in the parathyroid axis, characterized by elevated levels of PTH. Arq Bras Endocrinol Metab. 2014;58(6):619-24Keywords Lithium; parathyroid; mineral metabolism; hyperparathyroidism RESUMO Objetivo: Avaliar a função paratireoidiana e o metabolismo mineral em pacientes psiquiátricos usuários de sais de lítio. Materiais e métodos: Foram avaliados os níveis séricos de cálcio total, cálcio iônico, fósforo inorgânico, fosfatase alcalina, albumina, paratormônio (PTH), ureia, creatinina, 25-hidroxivitamina D e lítio de 35 pacientes diagnosticados com transtorno afetivo bipolar usuários de carbonato de lítio (CL) há pelo menos um ano (Grupo Lítio -GL) e 35 indivíduos saudáveis (Grupo Controle -GC). Resultados: O GL e o GC foram pareados por sexo e idade. Somente se observou diferença estatística em relação aos níveis de PTH e cálcio iônico, com p < 0,004 e p < 0,03, respectivamente. Hiperparatireoidismo secundário foi encontrado em oito (22.8%) pacientes do GL e em nenhum do GC. No GL, não houve correlação entre litemia, tempo de uso e posologia do CL. Conclusão: Nossos dados demonstram que o lítio pode suscitar um desequilíbrio no eixo paratireoideano, caracterizado por níveis elevados de PTH. Arq Bras Endocrinol Metab. 2014;58(6):619-24 Descritores Lítio; paratireoide; metabolismo mineral; hiperparatireoidismo

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“…Adherence to treatment refers to the extent to which patients accept and follow the recommendations made by physicians or other health professionals regarding the use of a particular therapy (Cramer et al, 2008;Rosa et al, 2006;Dewulf et al, 2006;Santin, Cereser, Rosa, 2005).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of adherence to treatment by patients seen in a psychosocial care center in northeastern Brazil

Souza

Silva

Onofre

et al. 2011

Braz. J. Pharm. Sci.

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In the treatment of mental disorders, nonadherence to medication, the main cause of psychiatric morbidity, is observed in about 50% of the cases and is responsible for numerous losses. This study evaluated adherence to drug treatment by patients seen in a Psychosocial Care Center (CAPS) in northeastern Brazil. Adherence to treatment was evaluated using the Haynes-Sackett and Morisky-Green-Levine tests. All patients registered in the CAPS were included in the study (n= 101). Only 11.88% of the patients adhered to drug treatment. The main reasons not to use medication were: oblivion (68.83%), feeling unwell after taking the medication (54.22%), not having money to buy the medication (43.83%), not finding the medication in the public health service (39.94%) and fear of harm that might be caused by the drug (28.90%). Furthermore, 85.1% of the patients did not know their diseases, 88.1% did not know their treatment, 86.4% did not feel good when they took their medication, and 88.1% took their medication incorrectly. The results revealed that the lack of information about diseases and drugs used, the nuisance posed by drug therapy and the low access to medications reduce adherence to treatment and, consequently, treatment effectiveness.Uniterms: Treatment adherence. Drug therapy/adherence to treatment. Mental health. Psychosocial Care Center.No tratamento de desordens mentais, a não-adesão ao tratamento ocorre em cerca de 50% dos casos e é responsável por inúmeros prejuízos, além de ser a principal causa de morbidade psiquiátrica. O presente estudo objetivou avaliar a adesão ao tratamento medicamentoso de pacientes atendidos em um Centro de Atenção Psicossocial (CAPS) no Nordeste do Brasil. A avaliação da adesão ao tratamento foi feita através dos testes de Haynes-Sackett e Morisky-Green-Levine. Todos os pacientes cadastrados no CAPS foram incluídos no estudo (n = 101). Observou-se que apenas 11,88% dos pacientes aderiram ao tratamento medicamentoso. As principais razões para o não uso dos medicamentos foram: esquecimento (68,83%), sentir-se mal após a ingestão de medicamentos (54,22%), não ter dinheiro para comprar medicamentos (43,83%), não encontrar os medicamentos no serviço público de saúde (39,94%) e medo dos danos causados pelos medicamentos (28,90%). Além disso, observou-se que 85,1% dos pacientes não conheciam suas doenças, 88,1% não conheciam seus tratamentos, 86,4% não se sentiam bem quando usavam medicamentos e 88,1% usavam os medicamentos incorretamente. Os resultados demonstram que a falta de informação sobre doenças e medicamentos, os danos decorrentes da terapia medicamentosa e o baixo acesso aos medicamentos comprometem a adesão ao tratamento e, consequentemente, a eficácia do tratamento. INTRODUCTIONPoor adherence to medications prescribed for chronic conditions has been cited as a global problem that may lead to increased morbidity and mortality (WHO, 2003; NEHI, 2009). It increases the costs within healthcare systems and contributes to substantial worsening of disease control and quality of life ...

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Monitoramento da adesão ao tratamento com lítio

Cited by 26 publications

References 22 publications

Bipolar disorder and medication: adherence, patients' knowledge and serum monitoring of lithium carbonate

Bipolar disorder and medication: adherence, patients' knowledge and serum monitoring of lithium carbonate

Evaluation of parathyroid function and mineral metabolism in psychiatric patients using lithium salts

Evaluation of adherence to treatment by patients seen in a psychosocial care center in northeastern Brazil

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