title: Adherence to lithium in naturalistic settings: results from a nationwide pharmacoepidemiological study.
abstract: OBJECTIVE
  To estimate adherence to lithium in a nationwide sample of all patients treated with lithium and to characterize adherence according to gender and age.
  
  
  METHODS
  Adherence to lithium was estimated using data obtained by linking Medicinal Product Statistics with the Danish Medical Register on Vital Statistics, identifying all persons who received lithium among the 5.3 million persons living in Denmark during the period 1995 to 2000 inclusive.
  
  
  RESULTS
  The median time to discontinuation of lithium was 181.0 days [95% confidence interval (CI) 135.7-181.0] and 25% of patients stopped treatment with lithium within 45.2 days. Adherence to lithium was significantly poorer for women (135.7 days; 95% CI 90.5-135.7) than for men (316.7 days; 95% CI 271.4-407.1) and for younger (18-39 years) and older (>or=60 years) patients compared to middle-aged patients.
  
  
  CONCLUSIONS
  The results highlight the need for increased focus on long-term adherence to lithium with intensified psychological support, especially among younger and older female patients.
authors.affiliation: Department of Psychiatry, University Hospital of Copenhagen, Rigshospitalet, University of Copenhagen, Denmark. lars.kessing@rh.dk
authors.forename: Lars Vedel
authors.initials: LV
authors.lastname: Kessing
authors.forename: Lars
authors.initials: L
authors.lastname: Søndergård
authors.forename: Kajsa
authors.initials: K
authors.lastname: Kvist
authors.forename: Per Kragh
authors.initials: PK
authors.lastname: Andersen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002951:Citrates / Q000627:therapeutic use; D003718:Denmark / Q000453:epidemiology; D004363:Drug Utilization; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016651:Lithium Carbonate / Q000627:therapeutic use; D018020:Lithium Compounds / Q000627:therapeutic use*; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017891:Pharmacoepidemiology / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data; D012737:Sex Factors
chemical_list: D002951:Citrates; D018020:Lithium Compounds; D016651:Lithium Carbonate; C070669:lithium citrate