Providing effective therapeutic drug monitoring services

Therapeutic drug monitoring (TDM) can be an effective way to improve care, but only if accurate medication and clinical information necessary to interpret results is available. A multidisciplinary team consisting of medical technologists, clinical pharmacists, and physician pharmacologists is described in detail. This service analyzes and interprets more than 20,000 concentrations per year, most of which are interpreted by specially trained medical technologists. A description of the interactions between members of the team is presented, including qualifications, selection, and training of medical technologists. The outcome of the TDM service from reporting of drug concentrations to daily quality assurance activities is described, as are the benefits of this model relative to other published, mostly pharmacy-based services. A case is made for the routine involvement of specially trained medical technologists in the collection of data and interpretation of drug concentrations.