The impact and acceptability of a central register on the standard of monitoring of lithium therapy: professional and patient perspectives

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ObjectiveTo ascertain whether a central (district) computerised register improves the standard of monitoring of patients on lithium therapy and to assess its acceptability to clinicians and patients.DesignA pilot study with a before and after audit, with questionnaires for clinicians and patients.SettingGeneral medical practices in Leicestershire from two localities.Participants17 practices, 91 patients and 42 clinicians.InterventionsSetting up a central lithium register which sent out regular reminders to patients for blood tests. An educational meeting was also held.Main outcome measuresAudit results for compliance with evidence-based criteria and patient satisfaction.ResultsThere appeared to be more frequent monitoring of lithium levels (+10.2%), renal function (+19.0%) and issuing of patient-held lithium cards. However, the second data collection included several practices that did not take part in the first audit. Both clinicians (response rate 60%) and patients (response rate 42%) expressed satisfaction and wished the register to continue.ConclusionA central system of call and recall probably improves the quality of monitoring of patients on lithium and is acceptable to clinicians (both psychiatrists and general practitioners) and patients.

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