A survey of Saskatchewan family physicians, psychiatrists and pharmacists assessing barriers in lithium use
Bibliographic record
Abstract
Lithium is a popular mood stabilizer. Anecdotally, it is an underutilized medication in primary care. We conducted a survey of family physicians (FPs), pharmacists and psychiatrists in Saskatchewan to examine attitudes towards and knowledge of lithium use in bipolar disorder (BD). FPs, psychiatrists and pharmacists within Saskatchewan were contacted via email addresses provided by the Saskatchewan Medical Association, Pharmacy Association of Saskatchewan and Canadian Society of Hospital Pharmacists – Saskatchewan Branch and a link to an online survey provided. Responses were obtained from 209 participants – 30 psychiatrists, 103 FPs and 76 pharmacists. Lithium was considered a specialist medication by 63.11% of FPs and 70% of psychiatrists. Lithium was the first choice for maintenance treatment of BD by 31.03% of psychiatrists and 13.68% of FPs, atypical antipsychotics being preferred by both (37.93 and 44.21%, respectively). 72% of the FPs were hesitant to initiate lithium and yet 73.79% felt comfortable monitoring patients already on it. FPs hesitancy could be related to a lack of knowledge in initiating or adjusting lithium doses (53.9%), how the medication works (28.7%), need for blood tests (34.95%), concern about suicidal ideas (11.5%) and the feeling of needing more education on prescribing lithium (79%). 33.69% of FPs were unsure about reference lithium levels or did not use it for monitoring. Limited by small sample size, we observed significant apprehensions about prescribing lithium in this study, more should done in encouraging its use in BD management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".