Category: Federal Forum Posters
Purpose: Federal guidelines for the management of bipolar disorder recommend obtaining lithium serum concentrations every six months in patients with ongoing therapy. A clinical reminder for lithium monitoring was assigned within the electronic medical record that alerts providers when a patient is overdue for laboratory monitoring. The objective of this medication use evaluation is to assess prescribers’ adherence to this guideline after the implementation of this clinical reminder. This will be completed by reviewing the lithium laboratory monitoring dashboard to identify patients overdue for a lithium serum level.
Methods: The lithium laboratory monitoring dashboard generates a list of all patients on lithium with more than six months since a lithium serum level. This dashboard will be reviewed weekly from July 30, 2018 to September 21, 2018 to identify patients meeting criteria for evaluation. The electronic medical record will be used to collect the following data for each patient: age, division, prescriber, lithium dose, last lithium prescription fill date, last lithium laboratory result and date, if a lithium laboratory order is pending, date of last serum creatinine, date of last thyroid panel, dates of upcoming mental health and primary care appointments, and if the patient has had an appointment with the lithium prescriber since the clinical reminder was implemented on April 5, 2018. A standardized note will then be entered into the electronic medical record to alert the lithium prescriber that the patient is due for a lithium level. If appropriate, a lithium level will be ordered under the prescriber’s name to coincide with the upcoming appointment. Finally, the intervention will be documented in the dashboard to complete the review.
Results: Not applicable
Conclusion: Not applicable
Holly Dorscheid– PGY1 Pharmacy Resident, VA Nebraska-Western Iowa Health Care System- Lincoln Division, Lincoln, NE