Evaluation of Therapeutic Drug Monitoring Reporting in a Teaching Hospital in Taiwan

[Speaker] Yuhong Lin:1
[Co-author] Hsinhui Huang:1
1:Pharmacy, Kaohsiung Veterans General Hospital Tainan Branch, Taiwan

Background: Therapeutic Drug Monitoring (TDM) is always an important part of clinical practice for the clinical pharmacists. The purpose of TDM not only is able to make sure the therapeutic effects but also may prevent toxicity from overtaking medicines. For that reason, it has become more important to patients with renal or hepatic impairment. In order to make clinical healthcare professionals realize the importance of TDM, we do a yearly assessment of TDM reporting.
Methods: The study was a retrospective study. TDM reporting contains valproic acid, digoxin, lithium, carbamazepine, theophylline, diphenylhydantoin, vancomycin and phenobarbital. In addition, we do a sub-analysis regarding spontaneous recommendations of TDM by clinical pharmacists.
Results: Eight hundred and four TDM reporting were included in our analysis in 2016. Most of the TDM reporting were valproic acid (73.8%). Twenty-nine TDM cases were included in a sub-analysis. Majority of the spontaneous recommendations of TDM were valproic acid (48.3%) as well. ''Keep current dosage and measure the clinical response'' were in the majority of follow-up after measuring TDM (86.2%).
Conclusions: TDM definitely was an important skill for the clinical pharmacists. It can identify the most proper dosing regimen to get the best clinical response with minimal toxicity as well. Clinical pharmacists have to review patients' medical records and provide recommendations to clinical prescribers when target concentrations were not reached. Therefore, TDM was a vital information for healthcare professionals. In the future, we hope that we could set a TDM reminder of medical system to suggest prescribers performing TDM.

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