Factors associated with patients' knowledge of and attitudes towards treatment with lithium.
BACKGROUND
Treatment with lithium is often compromised by poor adherence, by side-effects and by patients' having serum levels outside the therapeutic range. These factors may be affected by patients' knowledge and attitudes towards lithium, and we set out to establish factors associated with knowledge about and attitudes towards lithium among a large representative sample of patients.


METHODS
Patients known to be taking lithium in Grampian during 1995 were surveyed postally during 1998 with the Lithium Knowledge Test (LKT) and the Lithium Attitudes Questionnaire (LAQ). Scores on these measures were analysed against patients' sociodemographic and clinical characteristics by stepwise multiple regression.


RESULTS
Of 742 patients, 411 (55%) completed an LKT and 362 (49%) completed an LAQ. Stepwise multiple regression established that positive attitudes towards lithium on the LAQ were associated with higher serum lithium levels (P=0.005) and with continuing to take lithium (P<0.001). Higher knowledge on the LKT was associated with positive attitudes on the LAQ (P=0.002), with younger age (P<0.001), and with shorter duration of treatment (P=0.01)


CONCLUSIONS
The study was retrospective and the response rate was relatively low.


CONCLUSIONS
Education about lithium is likely to be of particular importance in the elderly and 'refresher courses' are advisable for those who have been on lithium for lengthy periods. Interventions which modify attitudes, rather than enhancing knowledge, are likely to be helpful in promoting adherence.
Dharmendra
M S
MS
Royal Cornhill Hospital, Cornhill Road, Aberdeen, AB25 2ZH, UK.
Eagles
J M
JM
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D003071:Cognition; D005260:Female; D006801:Humans; D016651:Lithium Carbonate / Q000627:therapeutic use*; D008297:Male; D019964:Mood Disorders / Q000188:drug therapy*; D010349:Patient Compliance; D010353:Patient Education as Topic; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
D014150:Antipsychotic Agents; D016651:Lithium Carbonate