Sampling time and indications appropriateness for therapeutically monitored drugs at a teaching university hospital in Oman

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To evaluate prospectively the appropriateness of indications, sampling time and outcome of TDM requests at a teaching university hospital in Oman. Methods: A prospective cross-sectional study was conducted over a four months period; October 2013-January 2014 at the Sultan Qaboos University Hospital (SQUH), an 855 bed university teaching hospital. Appropriateness criteria for indications and sampling time were defined a priori. The evaluated drug's requests were for carbamazepine, phenytoin, phenobarbital, valproic acid, digoxin, gentamicin, amikacin, vancomycin, tobramycin, theophylline, lithium, and cyclosporine. Results: Of 733 evaluated TDM requisitions, the majority were for antibiotics (75.0%) followed by antiepileptics (10.5%) and cyclosporine (8.9%). Most of the requests had appropriate indication (78.2%), however, only 28.5% had appropriate sampling time. Results were applied by dosage adjustments in 65.8% of requests and some of the inappropriately sampled requests (15.3%) were used as a basis for modifying the dosage regimen. Of all the reported plasma concentrations 42.3%, 41.2%, and 16.5% were within, below and above the reference range, respectively. Conclusion: TDM service is much less than optimal in SQUH. A lot of effort needs to be carried out to improve TDM use in the developing countries as adjusting the doses on results that are based on wrong sampling time might expose patients to toxicity or therapeutic failure.

Original languageEnglish
Pages (from-to)458-462
Number of pages5
JournalSaudi Pharmaceutical Journal
Volume23
Issue number4
DOIs
Publication statusPublished - Sep 1 2015

Fingerprint

Oman
Teaching Hospitals
Pharmaceutical Preparations
Cyclosporine
Tobramycin
Amikacin
Digoxin
Carbamazepine
Valproic Acid
Phenytoin
Vancomycin
Theophylline
Phenobarbital
Gentamicins
Lithium
Anticonvulsants
Developing Countries
Reference Values
Cross-Sectional Studies
Anti-Bacterial Agents

Keywords

  • Developing countries
  • Plasma concentrations
  • Therapeutic drug monitoring

ASJC Scopus subject areas

  • Pharmaceutical Science
  • Pharmacology

Cite this

@article{73192fb5bf974074b4aeeef93251c4c6,
title = "Sampling time and indications appropriateness for therapeutically monitored drugs at a teaching university hospital in Oman",
abstract = "Objective: To evaluate prospectively the appropriateness of indications, sampling time and outcome of TDM requests at a teaching university hospital in Oman. Methods: A prospective cross-sectional study was conducted over a four months period; October 2013-January 2014 at the Sultan Qaboos University Hospital (SQUH), an 855 bed university teaching hospital. Appropriateness criteria for indications and sampling time were defined a priori. The evaluated drug's requests were for carbamazepine, phenytoin, phenobarbital, valproic acid, digoxin, gentamicin, amikacin, vancomycin, tobramycin, theophylline, lithium, and cyclosporine. Results: Of 733 evaluated TDM requisitions, the majority were for antibiotics (75.0{\%}) followed by antiepileptics (10.5{\%}) and cyclosporine (8.9{\%}). Most of the requests had appropriate indication (78.2{\%}), however, only 28.5{\%} had appropriate sampling time. Results were applied by dosage adjustments in 65.8{\%} of requests and some of the inappropriately sampled requests (15.3{\%}) were used as a basis for modifying the dosage regimen. Of all the reported plasma concentrations 42.3{\%}, 41.2{\%}, and 16.5{\%} were within, below and above the reference range, respectively. Conclusion: TDM service is much less than optimal in SQUH. A lot of effort needs to be carried out to improve TDM use in the developing countries as adjusting the doses on results that are based on wrong sampling time might expose patients to toxicity or therapeutic failure.",
keywords = "Developing countries, Plasma concentrations, Therapeutic drug monitoring",
author = "{Al Za'abi}, Mohammed and {Al Muqbali}, Juhina and Khalid Al-Waili",
year = "2015",
month = "9",
day = "1",
doi = "10.1016/j.jsps.2014.11.005",
language = "English",
volume = "23",
pages = "458--462",
journal = "Saudi Pharmaceutical Journal",
issn = "1319-0164",
publisher = "King Saud University",
number = "4",

}

TY - JOUR

T1 - Sampling time and indications appropriateness for therapeutically monitored drugs at a teaching university hospital in Oman

AU - Al Za'abi, Mohammed

AU - Al Muqbali, Juhina

AU - Al-Waili, Khalid

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Objective: To evaluate prospectively the appropriateness of indications, sampling time and outcome of TDM requests at a teaching university hospital in Oman. Methods: A prospective cross-sectional study was conducted over a four months period; October 2013-January 2014 at the Sultan Qaboos University Hospital (SQUH), an 855 bed university teaching hospital. Appropriateness criteria for indications and sampling time were defined a priori. The evaluated drug's requests were for carbamazepine, phenytoin, phenobarbital, valproic acid, digoxin, gentamicin, amikacin, vancomycin, tobramycin, theophylline, lithium, and cyclosporine. Results: Of 733 evaluated TDM requisitions, the majority were for antibiotics (75.0%) followed by antiepileptics (10.5%) and cyclosporine (8.9%). Most of the requests had appropriate indication (78.2%), however, only 28.5% had appropriate sampling time. Results were applied by dosage adjustments in 65.8% of requests and some of the inappropriately sampled requests (15.3%) were used as a basis for modifying the dosage regimen. Of all the reported plasma concentrations 42.3%, 41.2%, and 16.5% were within, below and above the reference range, respectively. Conclusion: TDM service is much less than optimal in SQUH. A lot of effort needs to be carried out to improve TDM use in the developing countries as adjusting the doses on results that are based on wrong sampling time might expose patients to toxicity or therapeutic failure.

AB - Objective: To evaluate prospectively the appropriateness of indications, sampling time and outcome of TDM requests at a teaching university hospital in Oman. Methods: A prospective cross-sectional study was conducted over a four months period; October 2013-January 2014 at the Sultan Qaboos University Hospital (SQUH), an 855 bed university teaching hospital. Appropriateness criteria for indications and sampling time were defined a priori. The evaluated drug's requests were for carbamazepine, phenytoin, phenobarbital, valproic acid, digoxin, gentamicin, amikacin, vancomycin, tobramycin, theophylline, lithium, and cyclosporine. Results: Of 733 evaluated TDM requisitions, the majority were for antibiotics (75.0%) followed by antiepileptics (10.5%) and cyclosporine (8.9%). Most of the requests had appropriate indication (78.2%), however, only 28.5% had appropriate sampling time. Results were applied by dosage adjustments in 65.8% of requests and some of the inappropriately sampled requests (15.3%) were used as a basis for modifying the dosage regimen. Of all the reported plasma concentrations 42.3%, 41.2%, and 16.5% were within, below and above the reference range, respectively. Conclusion: TDM service is much less than optimal in SQUH. A lot of effort needs to be carried out to improve TDM use in the developing countries as adjusting the doses on results that are based on wrong sampling time might expose patients to toxicity or therapeutic failure.

KW - Developing countries

KW - Plasma concentrations

KW - Therapeutic drug monitoring

UR - http://www.scopus.com/inward/record.url?scp=84942373905&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84942373905&partnerID=8YFLogxK

U2 - 10.1016/j.jsps.2014.11.005

DO - 10.1016/j.jsps.2014.11.005

M3 - Article

AN - SCOPUS:84942373905

VL - 23

SP - 458

EP - 462

JO - Saudi Pharmaceutical Journal

JF - Saudi Pharmaceutical Journal

SN - 1319-0164

IS - 4

ER -