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  1. Lithium use and discontinuation in a Health Maintenance Organization.

    Article - En anglais

    Objective 

    For decades, lithium has been prescribed to treat bipolar disorder.

    Its efficacy has been documented by clinical trials and by data from specialized clinics.

    An issue of considerable interest is the use of lithium in managed care systems.

    This project examined the use of lithium and its continuity of use by enrollees ofa health maintenance organization (HMO).

    Method 

    In a 6-year longitudinal cohort study, 1,594 lithium users aged 15 years and older who were enrolled in an HMO were followed from 1986-1991.

    Data were obtained from automated databases and from medical record review ofa random 5% subsample of the group (N=74).

    Results 

    Bipolar disorder was the most frequent morbidity treated.

    Eighty-four percent (N=62 of 74) received services from a psychiatrist.

    Annual prevalence of lithium use increased over the 6-year period from 1.4 to 2.3 persons per thousand HMO members.

    Duration of use varied widely with some long-term but many short-term users.

    Discontinuation of treatment was associated with elevated rates of psychiatric hospitalization and use of psychiatric emergency services.

    Lithium users were much more likely to receive a variety of other psychotropic drugs than nonusers of the same sex and age.

    Conclusions 

    Lithium use in this population was more often sporadic than continuous.

    Discontinuation of lithium was associated with psychiatric hospitalization. (...)

    Mots-clés Pascal : Lithium, Psychotrope, Epidémiologie, Chimiothérapie, Traitement, Etude longitudinale, Trouble bipolaire, Trouble humeur, Etats Unis, Amérique du Nord, Amérique, Homme, Soin coordonné, Filière soin, Health Maintenance Organization

    Mots-clés Pascal anglais : Lithium, Psychotropic, Epidemiology, Chemotherapy, Treatment, Follow up study, Bipolar disorder, Mood disorder, United States, North America, America, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0395482

    Code Inist : 002B02B02. Création : 10/04/1997.