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Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
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Related Experiment Video

Updated: May 25, 2026

A Protocol for Analyzing Hepatitis C Virus Replication
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Published on: June 26, 2014

Developing a modified directly observed therapy intervention for hepatitis C treatment in a methadone maintenance

R Douglas Bruce1, Julie Eiserman, Angela Acosta

  • 1Yale University AIDS Program, New Haven, CT 06510, USA. robert.bruce@yale.edu

The American Journal of Drug and Alcohol Abuse
|January 17, 2012
PubMed
Summary
This summary is machine-generated.

Hepatitis C treatment integrated into methadone clinics shows high success rates. Modified directly observed therapy (mDOT) improved treatment adherence and virologic response in patients on methadone maintenance treatment (MMT).

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Hepatitis C virus (HCV) infection is common in patients receiving methadone maintenance treatment (MMT).
  • Limited randomized controlled trials (RCTs) exist for HCV treatment adherence in this population.
  • This study addresses the need for integrated HCV treatment within MMT programs.

Purpose of the Study:

  • To evaluate the efficacy and adherence of a modified directly observed therapy (mDOT) for HCV treatment integrated into MMT.
  • To compare mDOT with standard self-administered therapy (SAT) at a liver specialty clinic.
  • To assess the feasibility of delivering HCV treatment within MMT settings.

Main Methods:

  • A randomized controlled trial (RCT) comparing mDOT within MMT to SAT at a liver clinic.
  • Stratified randomization based on HIV status and HCV genotype.
  • Pilot study enrolling 21 subjects to date.

Main Results:

  • mDOT demonstrated higher treatment initiation rates.
  • 10 of 12 mDOT subjects achieved early virologic response (EVR) at week 12.
  • 6 of 10 mDOT subjects achieved sustained virologic response (SVR), compared to 1 of 9 SAT subjects.

Conclusions:

  • HCV treatment integration into methadone clinics is feasible and effective.
  • mDOT, utilizing existing clinic staff, enhances treatment adherence and outcomes.
  • On-site clinical services and adherence support in MMT settings can improve HCV treatment completion for patients with comorbidities.