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dc.contributor.authorNorris, Rossen_US
dc.contributor.authorH. Martin, Jenniferen_US
dc.contributor.authorThompson, Erinen_US
dc.contributor.authorE. Ray, Johnen_US
dc.contributor.authorO. Fullinfaw, Roberten_US
dc.contributor.authorJoyce, Daviden_US
dc.contributor.authorBarras, Michaelen_US
dc.contributor.authorR. Jones, Grahamen_US
dc.contributor.authorG. Morris, Raymonden_US
dc.description.abstractThe measurement of drug concentrations, for clinical purposes, occurs in many diagnostic laboratories throughout Australia and New Zealand. However, the provision of a comprehensive therapeutic drug monitoring (TDM) service requires the additional elements of pre- and postanalytical advice to ensure that concentrations reported are meaningful, interpretable, and clinically applicable to the individual patient. The aim of this project was to assess the status of TDM services in Australia and New Zealand. A range of professions involved in key aspects of TDM was surveyed by questionnaire in late 2007. Information gathered included: the list of drugs assayed; analytical methods used; interpretation services offered; interpretative methods used; and further monitoring advice provided. Fifty-seven responses were received, of which 42% were from hospitals (public and/or private); 11% a hospital (public and/or private) and pathology provider; and 47% a pathology provider only (public and/or private). Results showed that TDM is applied to a large number of different drugs. Poorly performing assay methods were used in some cases, even when published guidelines recommended alternative practices. Although there was a wide array of assays available, the evidence suggested a need for better selection of assay methods. In addition, only limited advice and/or interpretation of results was offered. Of concern, less than 50% of those providing advice on aminoglycoside dosing in adults used pharmacokinetic tools with six of 37 (16.2%) respondents using Bayesian pharmacokinetic tools, the method recommended in the Australian Therapeutic Guidelines: Antibiotic. In conclusion, the survey highlighted deficiencies in the provision of TDM services, in particular assay method selection and both quality and quantity of postanalytical advice. A range of recommendations, some of which may have international implications, are discussed. There is a need to include measures of impact on clinical decision-making when assessing assay methodologies. Best practice guidelines and professional standards of practice in TDM are needed, supported by an active program of professional development to ensure the benefits of TDM are realized. This will require significant partnerships between the various professions involved.en_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.publisher.placeUnited Statesen_US
dc.relation.ispartofjournalTherapeutic Drug Monitoringen_US
dc.subject.fieldofresearchPharmacology and Pharmaceutical Sciences not elsewhere classifieden_US
dc.titleCurrent Status of Therapeutic Drug Monitoring in Australia and New Zealand: A Need for Improved Assay Evaluation, Best Practice Guidelines, and Professional Developmenten_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
gro.facultyGriffith Health, School of Pharmacyen_US
gro.hasfulltextNo Full Text

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