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

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Objective To 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.

Design A pilot study with a before and after audit, with questionnaires for clinicians and patients.

Setting General medical practices in Leicestershire from two localities.

Participants 17 practices, 91 patients and 42 clinicians.

Interventions Setting up a central lithium register which sent out regular reminders to patients for blood tests. An educational meeting was also held.

Main outcome measures Audit results for compliance with evidence-based criteria and patient satisfaction.

Results There 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.

Conclusion A 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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Document Type: Research Article

Affiliations: 1: Director, Leicestershire Primary Care Audit Group, Leicester, UK 2: Consultant Pathologist, University Hospitals of Leicester, Leicester, UK 3: General Practitioner, Sileby, Leicestershire, UK 4: Consultant Psychiatrist, Leicestershire & Rutland Healthcare Trust, Leicester, UK 5: Clinical Governance Manager, South Charnwood Primary Care Group, Leicester, UK 6: Manager, Leicestershire Primary Care Audit Group, Leicester, UK

Publication date: September 1, 2002

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