Pharmacist-directed vancomycin therapeutic drug monitoring in pediatric patients: a collaborative-practice model
Background Therapeutic drug monitoring (TDM) of Vancomycin (VCM) is required to prevent inappropriate dosage-associated bacterial resistance, therapeutic failure, and toxicities in pediatrics. Anecdotal experience and studies show that many healthcare institutions confront barriers while implementin...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-12-01
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| Series: | Journal of Pharmaceutical Policy and Practice |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1186/s40545-021-00383-y |
| _version_ | 1797401308741763072 |
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| author | Kashif Hussain Rahila Ikram Gul Ambreen Muhammad Sohail Salat |
| author_facet | Kashif Hussain Rahila Ikram Gul Ambreen Muhammad Sohail Salat |
| author_sort | Kashif Hussain |
| collection | DOAJ |
| description | Background Therapeutic drug monitoring (TDM) of Vancomycin (VCM) is required to prevent inappropriate dosage-associated bacterial resistance, therapeutic failure, and toxicities in pediatrics. Anecdotal experience and studies show that many healthcare institutions confront barriers while implementing TDM services, this study aimed to assess a pharmacist-directed VCM–TDM service for optimizing patient care in our institution. Materials and methods Patients aged 1 month–18 years who received intravenous VCM were included in this quasi-experimental study. The pre-implementation phase (March–June 2018) consisted of retrospective assessment of pediatric patients, the interventional phase (July 2018 to February 2020) included educational programs and the post-implementation phase (March–June 2020) evaluated the participants based on pharmacist-directed VCM–TDM services as a collaborative-practice model including clinical and inpatient pharmacists to provide 24/7 TDM services. Outcomes of the study included the mean difference in the number of optimal (i) prescribed initial VCM doses (primary) (ii) dosage adjustments and (iii) VCM-sampling time (secondary). After ethical approval, data were collected retrospectively. Results A hundred patients were there in each phase. The number of cases who were correctly prescribed initial VCM doses was significantly higher in the post-implementation phase, mean difference of 0.22, [95% CI (0.142–0.0.358), p < 0.0001]. Patients who had correct dosage adjustments in the post-implementation phase also had higher statistical significance, mean difference of 0.29, [95% CI (0.152–0.423), p < 0.05]. More correct practices of VCM-levels timing were observed in the post-implementation phase, mean difference of 0.15, [95% CI (− 0.053–0.264), p = 0.079]. Conclusion This study showed the significant role of pharmacist-directed TDM services to optimize the correct prescribing of initial VCM doses and dose adjustments. |
| first_indexed | 2024-03-09T02:08:04Z |
| format | Article |
| id | doaj.art-d8a77add683043fc942fb818ac2a6fe7 |
| institution | Directory Open Access Journal |
| issn | 2052-3211 |
| language | English |
| last_indexed | 2024-03-09T02:08:04Z |
| publishDate | 2021-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Pharmaceutical Policy and Practice |
| spelling | doaj.art-d8a77add683043fc942fb818ac2a6fe72023-12-07T15:28:04ZengTaylor & Francis GroupJournal of Pharmaceutical Policy and Practice2052-32112021-12-0114110.1186/s40545-021-00383-y12315291Pharmacist-directed vancomycin therapeutic drug monitoring in pediatric patients: a collaborative-practice modelKashif Hussain0Rahila Ikram1Gul Ambreen2Muhammad Sohail Salat3Department of Pharmacy,Department of Pharmacology - Faculty of Pharmacy and Pharmaceutical Sciences,Department of Pharmacy,Department of Paediatrics and Child Health,Background Therapeutic drug monitoring (TDM) of Vancomycin (VCM) is required to prevent inappropriate dosage-associated bacterial resistance, therapeutic failure, and toxicities in pediatrics. Anecdotal experience and studies show that many healthcare institutions confront barriers while implementing TDM services, this study aimed to assess a pharmacist-directed VCM–TDM service for optimizing patient care in our institution. Materials and methods Patients aged 1 month–18 years who received intravenous VCM were included in this quasi-experimental study. The pre-implementation phase (March–June 2018) consisted of retrospective assessment of pediatric patients, the interventional phase (July 2018 to February 2020) included educational programs and the post-implementation phase (March–June 2020) evaluated the participants based on pharmacist-directed VCM–TDM services as a collaborative-practice model including clinical and inpatient pharmacists to provide 24/7 TDM services. Outcomes of the study included the mean difference in the number of optimal (i) prescribed initial VCM doses (primary) (ii) dosage adjustments and (iii) VCM-sampling time (secondary). After ethical approval, data were collected retrospectively. Results A hundred patients were there in each phase. The number of cases who were correctly prescribed initial VCM doses was significantly higher in the post-implementation phase, mean difference of 0.22, [95% CI (0.142–0.0.358), p < 0.0001]. Patients who had correct dosage adjustments in the post-implementation phase also had higher statistical significance, mean difference of 0.29, [95% CI (0.152–0.423), p < 0.05]. More correct practices of VCM-levels timing were observed in the post-implementation phase, mean difference of 0.15, [95% CI (− 0.053–0.264), p = 0.079]. Conclusion This study showed the significant role of pharmacist-directed TDM services to optimize the correct prescribing of initial VCM doses and dose adjustments.http://dx.doi.org/10.1186/s40545-021-00383-ytherapeutic drug monitoringpharmacistvancomycinpediatrictdm |
| spellingShingle | Kashif Hussain Rahila Ikram Gul Ambreen Muhammad Sohail Salat Pharmacist-directed vancomycin therapeutic drug monitoring in pediatric patients: a collaborative-practice model Journal of Pharmaceutical Policy and Practice therapeutic drug monitoring pharmacist vancomycin pediatric tdm |
| title | Pharmacist-directed vancomycin therapeutic drug monitoring in pediatric patients: a collaborative-practice model |
| title_full | Pharmacist-directed vancomycin therapeutic drug monitoring in pediatric patients: a collaborative-practice model |
| title_fullStr | Pharmacist-directed vancomycin therapeutic drug monitoring in pediatric patients: a collaborative-practice model |
| title_full_unstemmed | Pharmacist-directed vancomycin therapeutic drug monitoring in pediatric patients: a collaborative-practice model |
| title_short | Pharmacist-directed vancomycin therapeutic drug monitoring in pediatric patients: a collaborative-practice model |
| title_sort | pharmacist directed vancomycin therapeutic drug monitoring in pediatric patients a collaborative practice model |
| topic | therapeutic drug monitoring pharmacist vancomycin pediatric tdm |
| url | http://dx.doi.org/10.1186/s40545-021-00383-y |
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