Implementation and Evaluation of a Pilot Pharmacist-Led Vancomycin Therapeutic Drug Monitoring Service in an Acute General Hospital
Publication in refereed journal

香港中文大學研究人員

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摘要Objectives
To examine whether the pharmacist-managed vancomycin therapeutic drug monitoring (TDM) could optimize vancomycin dosage and monitoring
Methods
This was a retrospective cohort study with historical control. Serum vancomycin trough level (VANT) of patients treated with vancomycin under usual care from Sep 2014–Jan 2015 (historical control, CTRL) were compared to those treated with vancomycin therapy via a piloted pharmacist-managed TDM program from Sep 2015–Jan 2016 (intervention group, INTN).
Results
One hundred and six patients, 52 in INTN and 54 in CTRL, were included in the study. Of the 126 and 114 VANTs obtained from INTN and CTRL, 97 (77%) and 62 (54.3%) were regarded as appropriately timed trough concentrations for INTN and CTRL respectively (P < 0.001). VANT target achievement rate rose from 16.7% to 42.3% (NNT = 4, P = 0.005). Survival analysis showed the mean time to first VANT target achievement was shorter in INTN group, with 12.12 days and 33.8 days in INTN and CTRL respectively (HR = 4.873, P <0.001). Dosage adjustment when blood concentrations were outside VANT target were 50% and 62% in CTRL and INTN, respectively (P = 0.159). Rates of VANT rechecked after dosage adjustment was similar in both groups (INTN 76% vs CTRL 75%) (P = 0.916).
Conclusions
The implementation of pharmacist-managed vancomycin therapeutic monitoring service across medical and orthopedics units significantly reduced the time to target VANT. Improvements can be seen in the increased proportion of patients achieving targeted VANT and reduced mistimed troughs.
著者EM Cheung, KY Mo, TM Ng, WY Leung, TT Lam
期刊名稱Value in Health
出版年份2018
月份9
卷號21
期次Suppl. 2
頁次S62 - S62
國際標準期刊號1098-3015
語言美式英語

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