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Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

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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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Modified-release (MR) dosage forms are designed to extend drug release over time, thereby maintaining stable plasma concentrations and reducing dosing frequency. However, their bioavailability is typically below 100% due to incomplete drug release and presystemic metabolism, and limitations in drug permeability across the gastrointestinal epithelium, all of which can restrict the fraction of the drug reaching systemic circulation. Consequently, studying the in vivo bioavailability of MR...
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Modified-release drug delivery systems are designed to optimize the therapeutic effect of drugs by minimizing side effects, reducing the dosage required, and controlling drug release to align with pharmacokinetic and pharmacodynamic needs. The system depends on two key factors: the drug's release from the formulation and its movement through the body to the target site. Unlike conventional dosage forms, where absorption is the limiting step, the rate of drug release is the key determinant in...
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Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood at designated intervals to ensure the drug concentration stays within a therapeutic range. This monitoring is crucial for optimizing individual dosage regimens, enhancing therapeutic efficacy, and minimizing drug-related toxicity. TDM is vital for drugs with narrow therapeutic windows, significant variability in pharmacokinetics, and a clear correlation between plasma levels and...
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Modified-release dosage forms are designed to address the limitations of drugs with short biological half-lives. These forms maintain stable therapeutic drug concentrations over extended periods, reducing the need for frequent dosing. A consistent drug level helps minimize peak-trough fluctuations, which can reduce adverse effects, lower the risk of drug resistance, and improve overall treatment effectiveness.One common type of modified-release form is the extended-release (ER) formulation. ER...
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Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
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The availability, functionality, and quality of mobile applications supporting medication self-management.

Stacy Cooper Bailey1, Lisa T Belter, Anjali U Pandit

  • 1Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA.

Journal of the American Medical Informatics Association : JAMIA
|October 29, 2013
PubMed
Summary

Hundreds of mobile apps exist for medication self-management, but their quality and features vary widely. Further research is needed to identify optimal capabilities and clinical benefits for these patient support tools.

Keywords:
medication managementmobile technologyprescription medication

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Area of Science:

  • Health Informatics
  • Patient Self-Management
  • Mobile Health (mHealth)

Background:

  • Mobile applications offer a potential avenue for patients to manage their medications outside of clinical settings.
  • The proliferation of mHealth tools necessitates a systematic evaluation of their utility and quality for medication self-management.

Purpose of the Study:

  • To systematically review and assess mobile applications designed to support outpatient medication self-management for adult patients.

Main Methods:

  • A comprehensive search of three online stores in March 2013 identified 14,893 applications.
  • A multi-step review process by two independent reviewers selected 424 eligible applications based on predefined criteria.
  • User reviews from a subsample were qualitatively coded to identify common criticisms.

Main Results:

  • Eligible applications had an average user rating of 2.8 stars.
  • Most applications offered medication reminders (91.0%), while fewer provided regimen organization (6.2%) or drug interaction checks (2.8%).
  • Common user criticisms included technical issues, medication compatibility problems, and missing features.

Conclusions:

  • A large number of mobile applications are available for medication self-management, exhibiting significant variability in quality and functionality.
  • Further research is essential to define optimal application features, evaluate their utility, and ascertain their clinical benefits.