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Published on: July 30, 2020
The Devil's Advocate Asks: To TDM or Not to TDM?
Chelsea B Swartchick1, Loralie J Langman1
1Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine and Science, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Abstract:
Therapeutic drug monitoring is useful when interpreted in full clinical context and as part of the patient's full clinical picture. Analytical variability, lack of assay harmonization, specimen-related problems, and mistimed collection can undermine result reliability and clinician faith in results. Patient-specific factors such as nonadherence, drug interactions, and pharmacokinetic variability further complicate interpretation. The authors emphasize that therapeutic ranges are not absolute targets and that drug concentrations should support, rather than replace, clinical judgment.
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