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Serum drug level utilization: a literature analysis.

T R Einarson, H J Segal, J L Mann

    The Canadian Journal of Hospital Pharmacy
    |March 10, 1989
    PubMed
    Summary
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    Inappropriate use of serum drug level assays is common, leading to significant waste in healthcare. Pharmacists can play a key role in improving drug monitoring and reducing these inefficiencies.

    Area of Science:

    • Clinical Pharmacy
    • Pharmacoeconomics
    • Laboratory Medicine

    Background:

    • Serum drug level assays are crucial for therapeutic drug monitoring.
    • Inappropriate utilization of these assays can lead to suboptimal patient care and increased healthcare costs.
    • Existing literature suggests a need to quantify the extent of assay misuse.

    Purpose of the Study:

    • To quantify and evaluate the extent of inappropriate utilization of serum drug level assays.
    • To categorize the types of inappropriate use (indication, sampling, use of results).
    • To compare inappropriate utilization rates between Canadian and American studies.

    Main Methods:

    • A literature analysis was conducted to identify relevant studies.
    • Studies meeting specific criteria regarding appropriate use were extracted.

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  • Inappropriate use was categorized, and data from Canadian and American studies were compared.

    • Main Results:

    • 35 studies met the criteria, revealing high rates of inappropriate utilization: 34.7% for indication, 47.2% for sampling, and 40.2% for use of results.
    • Overall inappropriate use averaged 58.8%, with annual waste estimated between $1,221 and $100,917 per hospital.
    • Canadian and American study results were comparable, with no significant differences.

    Conclusions:

    • Significant inappropriate utilization of serum drug level assays occurs, impacting patient care, personnel time, and costs.
    • There is a substantial opportunity for pharmacists to intervene and optimize the use of these assays.
    • Improving assay utilization can lead to considerable cost savings and enhanced patient outcomes.