Delivery of therapeutic drug monitoring services: survey of Australasian clinical pharmacology laboratories.
Therapeutic drug monitoring (TDM) services, like many diagnostic services in public hospitals, have been under scrutiny over recent years as funding has decreased. The Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT) sought to review clinical pharmacology departments to consider how the changes that have been implemented have affected the delivery of TDM in recent years. A questionnaire was sent to such departments and all those known to be delivering TDM services responded. The survey demonstrated that of the 11 departments contributing TDM assays, 10 had lost tests and staffing to general biochemistry departments; eight departments had been delivering research and development in TDM. The TDM tests retained in clinical pharmacology were typically the more complex chromatographic or labor-intensive toxicology tests or the more expensive immunoassays. If this direction in Australasia is typical of the situation internationally, it should be a matter of great concern to all those with a particular interest in TDM. Is the future of TDM to be one in which only rapid immunoassays will be provided, and by a staff not fully able to provide pharmacokinetic support and interpretation of such tests (i.e., to become simply number-generating services) despite all the pharmacoeconomic data that is increasingly available?
Morris
R G
RG
Department of Clinical Pharmacology, The Queen Elizabeth Hospital, Woodville, South Australia.
D001315:Australia; D003625:Data Collection; D016903:Drug Monitoring / Q000379:methods / Q000592:standards*; D006801:Humans; D010601:Pharmacology, Clinical; D010607:Pharmacy Service, Hospital; D017410:Practice Guidelines as Topic