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Spotlight Session - ASPEN

Session: Spotlight Poster Session C

(CSPOT14) Multinational prescribing trends of lithium from 2001 to 2019: a retrospective observational study using population-based databases from 17 countries and one special administrative region

Wednesday, August 28, 2024
8:00 AM – 1:30 PM CEST
Location: Foyer 3

    Presenting Author(s)

  • Adrienne Chan, PhD

    Lecturer
    Aston University
    Hong Kong SAR, Hong Kong

    • Co-Author(s)

  • SB

    Shahram Bahmanyar

    Centre for Psychiatry Research, Karolinska Institutet, Sweden, Sweden

  • Greta A. Bushnell, PhD, MSPH

    Assistant Professor
    Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA
    New Brunswick, United States

  • BC

    Bruce Carleton

    Division of Translational Therapeutics, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, Canada., Canada

  • AC

    Amy Hai Yan Chan

    School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand, New Zealand

  • SC

    Sharon Cook

    Center for Health Services Research, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey, United States

  • Stephen Crystal, Ph.D.

    Board of Governors Professor
    Center for Health Services Research, Rutgers University, United States

  • Kari Furu, MPH, PhD (she/her/hers)

    Senior researcher
    Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway., Norway

  • PG

    Patricia Garcia

    Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency of Medicines and Medical Devices (AEMPS), Madrid, Spain, Spain

  • Rosa Gini, PhD (she/her/hers)

    Head of Unit at ARS Toscana, Florence, Italy
    ARS Toscana, Florence, Italy
    Florence, Italy

  • JH

    Jeff Harrison, PhD, DipClinPharm, PGCertClinEd, BSc(Hons),

    Professor in Clinical Pharmacy and Director Pharmacoepidemiology and Outcomes Research
    School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand, New Zealand

  • UH

    Ulrike Haug, PhD

    Prof. Dr. sc. hum.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS
    Bremen, Germany

  • CH

    Christine Hsu

    Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA, United States

  • HJ

    Harpa Lind Jónsdóttir

    Faculty of Psychology, University of Iceland, Reykjavík, Iceland, Iceland

  • JK

    Joe Kai

    Primary Care Stratified Medicine (PRISM) research group, School of Medicine, University of Nottingham, Nottingham, UK, United Kingdom

  • Øystein Karlstad, MscPharm, PhD

    Senior researcher
    Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway.
    Oslo, Norway

  • Ju Hwan Kim, PharmD, PhD

    Research Assistant Professor
    School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
    Suwon, Republic of Korea

  • KK

    Kiyoshi Kubota

    NPO Drug Safety Research Unit Japan, Tokyo, Japan., Japan

  • Edward Chia-Cheng Lai, PhD (he/him/his)

    Professor
    Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Taiwan
    National Cheng Kung University
    Tainan City, Taiwan (Republic of China)

  • WL

    Wallis Lau, PhD

    Research Department of Practice and Policy, UCL School of Pharmacy, University College London, London, United Kingdom., United Kingdom

  • KL

    Kathy Li

    Division of Translational Therapeutics, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, Canada., Canada

  • Géric Maura, PhD

    PharmD/PhD
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Sweden

  • Anke Neumann, PhD

    Biostatistician
    EPI-PHARE
    Odenbach, Germany

  • VP

    Virginia Pate, MS

    Analyst
    University of North Carolina at Chapel Hill
    Chapel Hill, United States

  • Anton Pottegård, PhD, DMSc

    Professor
    University of Southern Denmark
    Odense M, Denmark

  • NQ

    Nadeem Qureshi

    Primary Care Stratified Medicine (PRISM) research group, School of Medicine, University of Nottingham, Nottingham, UK, United Kingdom

  • Lotte Rasmussen, MScPharm, PhD

    Assistant professor
    University of Southern Denmark
    Odense, Denmark

  • Johan Reutfors, MD, PhD

    Associate professor
    Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden., Sweden

  • ER

    Elizabeth E Roughead

    Clinical and Health Sciences, Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, SA, Australia, Australia

  • LS

    Leena Saastamoinen

    Research Unit, The Social Insurance Institution of Finland, PO Box 450, 00056, Kela, Helsinki, Finland, Finland

  • TS

    Tsugumichi Sato

    Department of Pharmacy, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan, Japan

  • Oliver Scholle, PhD (he/him/his)

    Research Associate
    Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Bremen, Germany

  • CS

    Catharina C. M. Schuiling-Veninga, PhD

    PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands, Netherlands

  • Chin-Yao Shen, MClinPharm

    Ph.D Candidate
    School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
    Institute of Clinical Pharmacy and Pharmaceutical Sciences
    Tainan, Taiwan (Republic of China)

  • Ju-Young Shin, PhD

    Associate Professor
    School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
    Suwon, Republic of Korea

  • Til Stürmer, MD, PhD (he/him/his)

    Professor
    University of North Carolina at Chapel Hill
    Chapel Hill, United States

  • Katja Taxis, PhD

    Professor
    Pharmaco-Therapy, -Epidemiology and -Economics, Faculty of Science & Engineering, University of Groningen, The Netherlands
    Groningen, Netherlands

  • MT

    Marco Tuccori, PharmD, PhD

    Unit of Adverse Drug Reactions Monitoring. University Hospital of Pisa; Unit of Pharmacology and Pharmacovigilance, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
    Pisa, Italy

  • HZ

    Helga Zoega

    Associate professor/professor
    Medicines Intelligence Research Program, School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia., Australia

  • Kenneth KC Man, PhD, CStat, FRSPH (he/him/his)

    Lecturer/Assistant Professor
    UCL School of Pharmacy
    London, United Kingdom

  • IW

    Ian Chi Kei Wong, PhD (he/him/his)

    Professor
    Centre for Safe Medication Practice and research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong

Background: Lithium remained the gold standard treatment for bipolar disorders. However, a decline in lithium use for bipolar disorder was observed in the United States, United Kingdom and other countries, potentially due to the rising popularity of alternative therapeutic options and concerns about the safety and demands on clinical monitoring of lithium use. It is unclear if the phenomenon is consistent across the world.

Objectives: This study aimed to characterise the multinational trends and patterns of lithium use.

Methods: We conducted a multinational drug utilisation study using population-based databases from 18 sites across East Asia, Oceania, North America, Northern, Southern, and Western Europe. Study populations consisted of all individuals who used lithium between Jan 1, 2001, and Dec 31, 2019 (subject to data availability). We estimated the annual prevalence of lithium use during the study period, by geographical region, age, and sex. We reported the average annual percentage changes to describe time trends of lithium use in the general population and the estimated population of patients with bipolar disorders.

Results: This study analysed 19 data sources from 2001 to 2019 to assess the trends and patterns of lithium use in 247 million individuals across the world. The multinational pooled prevalence of lithium use was 0.12%, with regional variations. The study found that lithium use prevalence in the general population remained stable in most sites with an annual average percentage change of -1.09% in Denmark to +0.66% in Japan. Overall, the multinational pooled prevalence of lithium use was low relative to the prevalence of bipolar disorders (13.75%) and was decreasing in eight out of 19 countries/region studied.

Conclusions: As lithium remains the most effective mood-stabilising treatment in patients with bipolar disorders, this shift away from lithium use may lead to suboptimal clinical management for some patients. Future studies should investigate whether these differences in lithium prescribing have an impact on different outcomes of bipolar disorder.