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GPs are struggling to monitor lithium levels properly and could fail to achieve quality points because of lack of IT systems and support, a new study concludes.

The researchers also warned GPs could be placing themselves at medicolegal risk after uncovering 'inadequate standards' of lithium monitoring.

Only 50 per cent of patients had a level recorded in the previous three months, according to the study, carried out in 2002 and published in Psychiatric Bulletin this month.

The audit of 18 practices in Eastern Hull PCT also found that 'alarmingly' two patients had no lithium level on record.

Study leader Dr David Lawley, consultant psychiatrist at Humber Mental Health Teaching NHS Trust, said a re-audit last autumn had found little improvement despite the inclusion of lithium monitoring in the quality framework.

'I would like to say I would expect things to have improved but without the systems to help GPs recognise and record patients on lithium I would not expect it to. It needs good and effective IT systems to enable GPs to identify people and recall them when necessary,' he said.

He added that GPs also needed more education in the safe prescribing of lithium.

The 2002 audit also found problems with screening for complications, with only two-thirds of patients having had their thyroid and renal function tested in the last year.

GPs are paid for monitoring lithium levels every six months.

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