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Therapeutic Drug Monitoring: Affecting Factors01:29

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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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It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...
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Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
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Medicines information services in a resource-limited setting.

Trung Hieu Trinh1, Jo-Anne Brien2, Huong Nguyen3

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Summary

Medicines information (MI) services in Vietnamese hospitals are limited, with pharmacovigilance being most common. Workforce and location significantly impact MI service availability, crucial for national health strategies.

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Area of Science:

  • Health Services Research
  • Pharmaceutical Services
  • Vietnam Healthcare System

Background:

  • Limited development of medicines information (MI) services in Vietnam despite national guidelines.
  • Importance of exploring health service development priorities and barriers in resource-limited settings.

Purpose of the Study:

  • To investigate the current status of medicines information (MI) services for healthcare professionals and patients in Vietnamese hospitals.

Main Methods:

  • Online questionnaire distributed to 1359 hospitals across Vietnam in 2018.
  • Included national, provincial, district, private, and other ministry hospitals.
  • 560 eligible responses from hospital pharmacists analyzed.

Main Results:

  • Pharmacovigilance was the most common MI service (91%), while MI for clinical case management (30%), nurse training (31%), and patient education (27%) were least common.
  • Number of pharmacists and geographical-economical area were key factors influencing MI service provision.
  • Hospital type (traditional medicine vs. others) showed some impact, but size, level, and specialization did not significantly affect MI service availability.

Conclusions:

  • Disparities in MI practices among Vietnamese hospitals are linked to workforce and geographical factors.
  • Findings offer insights for implementing national MI strategies in Vietnam and other developing nations.