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

Abstract

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.

Drug therapy for people with mental disorders in the view of nursing professionals

“…3 They are often delimited by the instability of the manifestation of symptoms as sometimes there are moments of remission and sometimes of exacerbation, characterized by delusions, hallucinations, agitation, self or hetero-aggressive behavior and social exposure. 3,4 In this sense, the person with a mental disorder often requires continuous treatment with multiple psychosocial interventions using a multiprofessional and interdisciplinary approach with psychotherapies, group and/or individual therapies, and drug therapy, among others. [4][5][6] Drug therapy, when applied rationally, aims to reduce the harmful symptoms resulting from the mental disorder, in order to better adapt the individual to reality.…”

“…3,4 In this sense, the person with a mental disorder often requires continuous treatment with multiple psychosocial interventions using a multiprofessional and interdisciplinary approach with psychotherapies, group and/or individual therapies, and drug therapy, among others. [4][5][6] Drug therapy, when applied rationally, aims to reduce the harmful symptoms resulting from the mental disorder, in order to better adapt the individual to reality. 5 Medications are commonly used to treat mental health cases with their easy availability and efficacy being responsible for the widespread use of this resource.…”

“…5,8,9 The nursing team, as part of the multi-professional health team, plays a fundamental role in drug therapy in mental health, after all, these professionals must have an active posture and are in contact with the patient every day and so that they have experience of the use of medications and the day-to-day life of patients. 4,5 Moreover, this treatment option is inserted in the professional practice of the nursing team, which should aim at humanized, systematized and integral care based on psychosocial rehabilitation supported by the precepts of the Psychiatric Reform. 4,6,9 Therefore, knowing how the nursing staff perceives drug therapy in mental health care is of paramount importance, since it is up to these professionals to administer, supervise and guide the patient about the prescribed medication.…”

“…4,5 Moreover, this treatment option is inserted in the professional practice of the nursing team, which should aim at humanized, systematized and integral care based on psychosocial rehabilitation supported by the precepts of the Psychiatric Reform. 4,6,9 Therefore, knowing how the nursing staff perceives drug therapy in mental health care is of paramount importance, since it is up to these professionals to administer, supervise and guide the patient about the prescribed medication. In addition to clarifying the reasons for the therapeutic indication, expected effects, frequency of administration, possible side effects and adverse effects, nursing professionals should be aware of how this therapy is perceived and experienced by the person with the mental disorder, because treatment success depends on the attitudes of these professionals.…”

“…In addition to clarifying the reasons for the therapeutic indication, expected effects, frequency of administration, possible side effects and adverse effects, nursing professionals should be aware of how this therapy is perceived and experienced by the person with the mental disorder, because treatment success depends on the attitudes of these professionals. 4,6 Given this context, this research aimed to know the perception of nursing professionals on the drug therapy given to people with mental disorders.…”