Therapeutic Drug Monitoring and Pharmacogenetic Testing in Northern China

Background: Therapeutic drug monitoring (TDM) and pharmacogenetic (PGx) testing are widely used as approaches to improve individualized (personalized) pharmacotherapy. Little is known about TDM and PGx testing services in China. This study is aimed to describe the TDM and PGx testing services in northern China, and to lay the foundation for improving these services.Methods: We developed an electronic survey using online software and disseminated it to 32 public hospitals in northern China from May to July 2019. The data were analyzed using the Statistical Package for Social Sciences (SPSS) program (Ver.27.0).Results: We collected 29 of the 32 questionnaires (90.6% response rate) from public hospitals in seven provinces of northern China. Twenty-two public hospitals (76%) utilized TDM; immune suppressants, antiepileptic drugs and anti-infective drugs were the main drugs monitored. The hospitals that did not provide TDM service were traditional Chinese medicine hospitals and hospitals with a smaller number of hospital beds. Seventeen public hospitals (58.6%) had PGx testing programs. The hospitals that did not offer PGx testing service had a smaller number of hospital beds and had fewer daily outpatients.Conclusion: TDM is available in the vast majority of public hospitals in northern China, although mainly in tertiary hospitals. PGx testing, a newer approach, is less widely available. We recommend that more hospitals be encouraged to provide TDM and PGx testing services and more efforts be directed toward quality control, delivery of results and counseling of patients based on those results.

Download Full-text

Evaluation of the knowledge of Health Care Professionals regarding Therapeutic Drug Monitoring in Public Hospitals of Lahore, Pakistan

Global Pharmaceutical Sciences Review ◽

10.31703/gpsr.2020(v-i).02 ◽

2020 ◽

Vol V (I) ◽

pp. 9-16

Author(s):

Anam Arshad ◽

Malik Irfan Zulfiqar ◽

Zahra Hassan Kiani ◽

Maria Hassan Kiani ◽

Muhammad Rauf ul Hassan

Keyword(s):

Health Care ◽

Therapeutic Drug Monitoring ◽

Drug Monitoring ◽

Health Care Professionals ◽

Medical Science ◽

Cross Sectional Study ◽

Public Hospitals ◽

Therapeutic Drug ◽

Cross Sectional ◽

Developed Country

A cross sectional study was performed among 250 health care professionals from Children Hospital, Jinnah hospital and Services Institute of Medical science Lahore, through a self-designed questionnaire to assess the knowledge of therapeutic drug monitoring (TDM). A total 300 questionnaires were distributed and 250 were returned, giving a response 83%. Out of 300 health care professionals 50 participants do not even know the term TDM. Only 40% participants strongly agreed that TDM is done for all patients. Only 26.8% participants agreed that TDM is carried out for all drugs. Only 63.2% participants agreed that the TDM is very costly process. Only 38.4% strongly agreed that TDM requires extra time of health care professionals and only 36% participants remain neutral to the perception that TDM is requested by patient rather than health care professionals. Limited resources and lack of technical skills are barriers in performing TDM in under-developed country like Pakistan.

Download Full-text

Diagnose und Monitoring bei chronisch-entzündlicher Darmerkrankung

Therapeutische Umschau ◽

10.1024/0040-5930/a001002 ◽

2018 ◽

Vol 75 (5) ◽

pp. 316-328

Author(s):

Christian Ansprenger ◽

Emanuel Burri

Keyword(s):

Therapeutic Drug Monitoring ◽

Drug Monitoring ◽

Morbus Crohn ◽

Therapeutic Drug ◽

Körperliche Untersuchung

Zusammenfassung. Die Diagnose und auch die Überwachung von chronisch entzündlichen Darmerkrankungen ruht auf mehreren Säulen: Anamnese, körperliche Untersuchung, Laborwerte (im Blut und Stuhl), Endoskopie, Histologie und Bildgebung. Die Diagnose kann nicht anhand eines einzelnen Befundes gestellt werden. In den letzten Jahren hat sich das Therapieziel weg von klinischen Endpunkten hin zu endoskopischen und sogar histologischen Endpunkten entwickelt. Für einige dieser neuen Therapieziele existiert allerdings noch keine allgemein gültige Definition. Regelmässige Endoskopien werden von Patienten schlecht toleriert, weshalb Surrogat-Marker wie Calprotectin untersucht wurden und eine gute Korrelation mit der mukosalen Entzündungsaktivität nachgewiesen werden konnte. Entsprechend zeigte sich bei Morbus Crohn eine Algorithmus-basierte Therapiesteuerung – unter anderem basierend auf Calprotectin – einer konventionellen Therapiesteuerung überlegen. Die Überwachung der medikamentösen Therapie («Therapeutic Drug Monitoring» [TDM]) ist ein zweites Standbein des Monitoring von chronisch entzündlichen Darmerkrankungen. Mit zunehmendem Einsatz vor allem der Biologika-Therapien wurden sowohl reaktives TDM (in Patienten mit klinischem Rezidiv) als auch proaktives TDM (in Patienten in Remission / stabiler Erkrankung) untersucht und haben (teilweise) Eingang in aktuelle Richtlinien gefunden. Zukünftige Studien werden die vorgeschlagenen Therapieziele besser definieren und den Nutzen der medikamentösen Therapieüberwachung auf den Krankheitsverlauf weiter untersuchen müssen.

Download Full-text