Best practice in therapeutic drug monitoring.
It is the goal of Therapeutic Drug Monitoring (TDM) to use drug concentrations to manage a patient's medication regimen and optimise outcome. Limited resources require that drug assays should only be performed when they do contribute to patient management. For this to be the case a therapeutic drug monitoring service has a far greater role than just therapeutic drug measuring. This article describes the roles and functions of a Best Practice TDM service. The features which can and should be strived for in each step of the TDM process-the decision to request a drug level, the biological sample, the request, laboratory measurement, communication of results by the laboratory, clinical interpretation and therapeutic management-are discussed.
Department of Clinical Pharmacology, Royal North Shore Hospital, St Leonards NSW, Australia.
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D016903:Drug Monitoring; D006801:Humans; D010601:Pharmacology, Clinical / Q000458:organization & administration* / Q000639:trends