Survey on the Development of Therapeutic Drug Monitoring in Chinese Hospitals in 2018 / 中国药学杂志

ABSTRACT

OBJECTIVE: To understand the development of therapeutic drug monitoring (TDM) in domestic hospitals and provide guidance for disciplinary development. METHODS: A range of professions involved in 7 aspects (33 questions) of TDM were surveyed by questionnaire on WeChat in late 2018. Information gathered included basic information, development of TDM laboratories and clinical departments, monitoring drug types and quantity, quality control, interpretation of reports and individual drug regimen, and approval and management. These data were exported in Excel, and the valid data were included. RESULTS: Five hundred and four responses were received, of which 463 were valid and included, of which 177 hospitals developed TDM. The results of the above 7 aspects which were from those 177 hospitals in 2018 were summarized as follows. The educational backgrounds were mainly the master degree (43%) and the bachelor degree (33%). Most hospitals (75%) established chromatographic methods. The monitoring items were mainly blood drug concentration test(63%) and drug genetic testing (36%). In all clinical departments, TDM was most applied in Neurology. Eleven categories of drugs applying TDM in 2018 were investigated, of which psychotic drugs with the most varieties included eighteen drugs, and immunosuppressive agents had the most samples monitoring (57%). Over one half of hospital (64%) carried out the quality control. Only one half of hospitals (89/177) developed clinical interpretation, of which 75% showed that clinical pharmacists participated in the interpretation; 82% developed individualized plans based on the results. Most hospitals (65%) carried out the TDM review and the systems of examination and approval, and TDM in 47% of the hospitals was included in the hospital pharmacy management and drug therapy committee management system. CONCLUSION: This survey has obtained information of the seven aspects, and has mastered the TDM profile of 11 categories of drugs in 2018. However, there is still insufficient development in the quality control, clinical interpretation, individualized regimen development and TDM management. In addition to conducting drug monitoring, TDM work in the future will focus on improving and developing the above deficiencies and promoting clinical rational drug use.