title: Impact of a therapeutic drug monitoring program for digoxin.
abstract: Although numerous utilization reviews of serum digoxin assays have demonstrated the positive impact of therapeutic drug monitoring, to our knowledge, the question of whether the withdrawal of such a program would reverse the effect has not been addressed. The current study employed a prospective, randomized, crossover design to evaluate this question and document the cost savings. There were 196 serum digoxin assays performed in the 207 patients. It was found that a continuous therapeutic drug-monitoring program was warranted since, after its withdrawal, there was a deterioration in audit criteria performance. Reimplementation of the therapeutic drug-monitoring program resulted in a significant decrease in the average number of assays requested per patient (from 1.41 to 0.73) and an improvement in audit criteria performance.
mesh_terms: D002170:Canada; D003363:Cost Control; D004077:Digoxin / Q000097:blood*; D004363:Drug Utilization; D006801:Humans; D008485:Medical Audit; D008991:Monitoring, Physiologic / Q000379:methods; D010607:Pharmacy Service, Hospital / Q000592:standards*; D011446:Prospective Studies; D011897:Random Allocation
chemical_list: D004077:Digoxin