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Perceptions of using lithium in fracture management: a survey of orthopaedic surgeons, fracture patients and the general public

BACKGROUND: Lithium, an established psychiatric medication, has recently been shown to enhance new bone formation in preclinical fracture models. Current research is focused on evaluating the efficacy of low-dose, short-term lithium treatment to improve long bone fracture healing through a Phase II...

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Autores principales: Vachhani, Kathak, Whyne, Cari M., Schaffer, Ayal, Nam, Diane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717343/
https://www.ncbi.nlm.nih.gov/pubmed/31470828
http://dx.doi.org/10.1186/s12891-019-2772-0
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author Vachhani, Kathak
Whyne, Cari M.
Schaffer, Ayal
Nam, Diane
author_facet Vachhani, Kathak
Whyne, Cari M.
Schaffer, Ayal
Nam, Diane
author_sort Vachhani, Kathak
collection PubMed
description BACKGROUND: Lithium, an established psychiatric medication, has recently been shown to enhance new bone formation in preclinical fracture models. Current research is focused on evaluating the efficacy of low-dose, short-term lithium treatment to improve long bone fracture healing through a Phase II randomized clinical trial (LiFT NCT02999022). In working towards future applications of lithium for fracture management, this study aimed to understand the current perceptions of lithium as a psychiatric drug and the potential barriers to its orthopaedic adoption. METHODS: Three questionnaires, evaluating knowledge about lithium and willingness to embrace its use in fracture healing were disseminated among the general population, fracture patients eligible for the LiFT (Lithium for Fracture Treatment) trial and orthopaedic surgeons across Canada. RESULTS: Of the 768 public respondents, 84% were willing to take a medication that would aid fracture healing but only 62.6% if the medication was lithium. Willingness dropped to 44.6% among the 168 respondents who knew about the psychiatric use of lithium. Lack of sufficient knowledge (n = 50) and concerns about side effects including effects on the brain (n = 74) were the main reasons cited by those who were unwilling to use lithium. Of the 29 fracture patients, only 20 patients had previously heard of lithium. Of these, 40% were willing to take lithium for fracture healing with an additional 10% if the dose was low or if the intake duration was short. Only 50% knew that lithium has side effects. Of the 43 orthopaedic surgeons, 38 surgeons knew about clinical use of lithium. Of these, 68% knew that lithium has side effects and 29% knew that it interacts with other drugs. While most agreed that new strategies are needed to improve fracture management, only 68% were willing to prescribe lithium for fractures with an additional 16% if there is scientific evidence and/or a standard dosing protocol. CONCLUSIONS: This study identified a lack of knowledge about uses and side effects of lithium among all three cohorts. A robust educational framework for orthopaedic surgeons, their patients and the members of their clinical care teams will be essential to widespread repurposing of lithium for fracture care. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12891-019-2772-0) contains supplementary material, which is available to authorized users.
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spelling pubmed-67173432019-09-06 Perceptions of using lithium in fracture management: a survey of orthopaedic surgeons, fracture patients and the general public Vachhani, Kathak Whyne, Cari M. Schaffer, Ayal Nam, Diane BMC Musculoskelet Disord Research Article BACKGROUND: Lithium, an established psychiatric medication, has recently been shown to enhance new bone formation in preclinical fracture models. Current research is focused on evaluating the efficacy of low-dose, short-term lithium treatment to improve long bone fracture healing through a Phase II randomized clinical trial (LiFT NCT02999022). In working towards future applications of lithium for fracture management, this study aimed to understand the current perceptions of lithium as a psychiatric drug and the potential barriers to its orthopaedic adoption. METHODS: Three questionnaires, evaluating knowledge about lithium and willingness to embrace its use in fracture healing were disseminated among the general population, fracture patients eligible for the LiFT (Lithium for Fracture Treatment) trial and orthopaedic surgeons across Canada. RESULTS: Of the 768 public respondents, 84% were willing to take a medication that would aid fracture healing but only 62.6% if the medication was lithium. Willingness dropped to 44.6% among the 168 respondents who knew about the psychiatric use of lithium. Lack of sufficient knowledge (n = 50) and concerns about side effects including effects on the brain (n = 74) were the main reasons cited by those who were unwilling to use lithium. Of the 29 fracture patients, only 20 patients had previously heard of lithium. Of these, 40% were willing to take lithium for fracture healing with an additional 10% if the dose was low or if the intake duration was short. Only 50% knew that lithium has side effects. Of the 43 orthopaedic surgeons, 38 surgeons knew about clinical use of lithium. Of these, 68% knew that lithium has side effects and 29% knew that it interacts with other drugs. While most agreed that new strategies are needed to improve fracture management, only 68% were willing to prescribe lithium for fractures with an additional 16% if there is scientific evidence and/or a standard dosing protocol. CONCLUSIONS: This study identified a lack of knowledge about uses and side effects of lithium among all three cohorts. A robust educational framework for orthopaedic surgeons, their patients and the members of their clinical care teams will be essential to widespread repurposing of lithium for fracture care. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12891-019-2772-0) contains supplementary material, which is available to authorized users. BioMed Central 2019-08-31 /pmc/articles/PMC6717343/ /pubmed/31470828 http://dx.doi.org/10.1186/s12891-019-2772-0 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Vachhani, Kathak
Whyne, Cari M.
Schaffer, Ayal
Nam, Diane
Perceptions of using lithium in fracture management: a survey of orthopaedic surgeons, fracture patients and the general public
title Perceptions of using lithium in fracture management: a survey of orthopaedic surgeons, fracture patients and the general public
title_full Perceptions of using lithium in fracture management: a survey of orthopaedic surgeons, fracture patients and the general public
title_fullStr Perceptions of using lithium in fracture management: a survey of orthopaedic surgeons, fracture patients and the general public
title_full_unstemmed Perceptions of using lithium in fracture management: a survey of orthopaedic surgeons, fracture patients and the general public
title_short Perceptions of using lithium in fracture management: a survey of orthopaedic surgeons, fracture patients and the general public
title_sort perceptions of using lithium in fracture management: a survey of orthopaedic surgeons, fracture patients and the general public
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717343/
https://www.ncbi.nlm.nih.gov/pubmed/31470828
http://dx.doi.org/10.1186/s12891-019-2772-0
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