| Back to main Menu |
| Back to Clinical |
(If the earliest prescription for lithium is after 1st January 2009, they will not be counted in the denominator population for this indicator)
d6...%
665B. Lithium stopped (recorded after last prescription issued
The number of points and indicators for Lithium have been reduced in recognition of the relatively small number of people this indicator applies to and the importance of the intermediate outcome of the lithium level being within the therapeutic range.
It is important to check thyroid and renal function on an annual basis since there is a much higher than normal incidence of hypercalcaemia and hypothyroidism in patients on lithium, and of abnormal renal function tests. Overt hypothyroidism has been found in between 8 per cent and 15 per cent of people on lithium.
See www.jr2.ox.ac.uk/bandolier/band74/b74-6.html
MH 4.2.1 Practices should report the percentage of patients on lithium therapy with a record of TSH in the last 15 months.
MH 4.2.2 Practices should report the percentage of patients on lithium therapy with a record of serum creatinine in the last 15 months.
In verifying that this information has been correctly recorded, a number of approaches could be taken by a PCO:
i. Inspection of the output from a computer search that has been used to provide information on this indicator.
ii. Inspection of a sample of records of patients on lithium therapy to look at the proportion with recorded TSH and creatinine in the last 15 months.
iii. Inspection of a sample of records of patients on lithium therapy for whom a record of TSH and creatinine is claimed, to see if there is evidence of this in the medical records.
Prepared By Jean Keenan