PMID: 19938743Nov 27, 2009Paper

Effect of pharmacist participation in the health care team on therapeutic drug monitoring utilization for antiepileptic drugs

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
Chaveewan RatanajamitDamrongsak Faroongsarng

Abstract

To compare the proportions of appropriate TDM utilization regarding the indication, sampling time, and application of the measured drug levels of antiepileptic drugs (AEDs) between the pre-intervention period and pharmacist intervention period. The baseline evaluation and pharmacist intervention study of TDM use for phenytoin, carbamazepine, or valproic acid were conducted at a medical teaching hospital in Southern Thailand. TDM requests, interpretation and dosage adjustment recommendations were mainly responsible by residents. In the intervention period, each of the three-step TDM process was assessed by the pharmacist for appropriateness and a suggestion provided if necessary prior to a final recommendation made by the resident. The criteria for appropriateness of TDM for AEDs were developed and validated by two neurologists. The present study included 44 TDM tests (22 patients) during the baseline period and 43 tests (27 patients) during the intervention period. The proportions of appropriate TDM utilization between the two periods were compared using Chi-square test. In the baseline period, proportions of appropriately performed TDM were: indication (63.6%), sampling time (47.7%), and application of drug levels (63.6%). Pha...Continue Reading

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