PDF(Pubmed)
Abstract：
To understand the status of therapeutic drug monitoring (TDM) in China Mainland, and thus lay down the foundation for further improvement in TDM.
In the present study, a nationwide questionnaire survey was conducted, which was distributed and collected using a mobile-based application. Clinicians, pharmacists, and clinical laboratory physicians belonging to different levels of public hospitals were involved as subjects/objects. The contents of the survey included TDM implementation in their hospital and information regarding their opinions and suggestions on TDM work. Mann-Whitney test was used to compare the difference between top tertiary hospitals and non-top tertiary hospitals.
A total of 475 questionnaires were collected, 383 from top tertiary hospitals (3A hospitals) and 92 from non-top tertiary hospitals (other than 3A hospitals). A total of 240 clinicians, TDM pharmacists, and clinical laboratory physicians were involved, with an effective rate of 50.5%. Top tertiary hospitals were associated with certain advantages, such as the number of TDM testing facilities, annual sample size, number of monitoring varieties, and interpretation rate of monitoring reports, compared with non-top tertiary hospitals. In particular, β-lactamase inhibitor, olanzapine, carbamazepine, and glucocorticoids seemed to be the main projects that clinicians wanted to assess. The drugs for which TDM was commonly performed included vancomycin, valproic acid, carbamazepine, phenytoin sodium, and methotrexate. The most commonly used detection methods include high-performance liquid chromatography, immunization, 2D-LC, and LC-MS. The monitoring concentration range was found to be inconsistent for most of the drugs. Currently, no unified regulation exists for TDM charges in China, which is no more than ¥200 in general. Clinicians rely on pharmacists for professional guidance. Importantly, improvement in the interpretation of monitoring reports, proficiency testing, and cooperation with clinical departments may aid in improving the level of TDM service.
This survey objectively reflected the current status of TDM work in hospitals in China, and provided a strong reference base for devising strategies for improvement and effective execution of TDM work.
In the present study, a nationwide questionnaire survey was conducted, which was distributed and collected using a mobile-based application. Clinicians, pharmacists, and clinical laboratory physicians belonging to different levels of public hospitals were involved as subjects/objects. The contents of the survey included TDM implementation in their hospital and information regarding their opinions and suggestions on TDM work. Mann-Whitney test was used to compare the difference between top tertiary hospitals and non-top tertiary hospitals.
A total of 475 questionnaires were collected, 383 from top tertiary hospitals (3A hospitals) and 92 from non-top tertiary hospitals (other than 3A hospitals). A total of 240 clinicians, TDM pharmacists, and clinical laboratory physicians were involved, with an effective rate of 50.5%. Top tertiary hospitals were associated with certain advantages, such as the number of TDM testing facilities, annual sample size, number of monitoring varieties, and interpretation rate of monitoring reports, compared with non-top tertiary hospitals. In particular, β-lactamase inhibitor, olanzapine, carbamazepine, and glucocorticoids seemed to be the main projects that clinicians wanted to assess. The drugs for which TDM was commonly performed included vancomycin, valproic acid, carbamazepine, phenytoin sodium, and methotrexate. The most commonly used detection methods include high-performance liquid chromatography, immunization, 2D-LC, and LC-MS. The monitoring concentration range was found to be inconsistent for most of the drugs. Currently, no unified regulation exists for TDM charges in China, which is no more than ¥200 in general. Clinicians rely on pharmacists for professional guidance. Importantly, improvement in the interpretation of monitoring reports, proficiency testing, and cooperation with clinical departments may aid in improving the level of TDM service.
This survey objectively reflected the current status of TDM work in hospitals in China, and provided a strong reference base for devising strategies for improvement and effective execution of TDM work.
摘要：
目的：了解中国大陆地区治疗药物监测（TDM）的现状，从而为进一步改进TDM奠定了基础。
方法：在本研究中，进行了全国性的问卷调查，它是使用基于移动的应用程序分发和收集的。临床医生,药剂师,不同级别公立医院的临床检验医师作为研究对象。调查内容包括他们医院的TDM实施情况以及他们对TDM工作的意见和建议。采用Mann-Whitney检验比较三甲医院与非三甲医院的差异。
结果：共收集了475份问卷，383家来自顶级三级医院（3A医院），92家来自非顶级三级医院（3A医院除外）。共有240名临床医生，TDM药剂师，临床检验医生也参与其中，有效率为50.5%。顶级三级医院具有某些优势，例如TDM测试设施的数量，年度样本量，监测品种数量，和监测报告的解释率，与非顶级三级医院相比。特别是,β-内酰胺酶抑制剂,奥氮平,卡马西平,糖皮质激素似乎是临床医生想要评估的主要项目.通常进行TDM的药物包括万古霉素，丙戊酸,卡马西平,苯妥英钠，和甲氨蝶呤.最常用的检测方法包括高效液相色谱法，免疫接种,2D-LC,和LC-MS发现大多数药物的监测浓度范围不一致。目前,中国没有统一的TDM收费规定，一般不超过200日元。临床医生依靠药剂师进行专业指导。重要的是,改进监测报告的解释，能力测试,与临床部门的合作可能有助于提高TDM服务水平。
结论:本次调查客观反映了我国医院TDM工作的现状,并为制定改进和有效执行TDM工作的策略提供了强有力的参考基础。
方法：在本研究中，进行了全国性的问卷调查，它是使用基于移动的应用程序分发和收集的。临床医生,药剂师,不同级别公立医院的临床检验医师作为研究对象。调查内容包括他们医院的TDM实施情况以及他们对TDM工作的意见和建议。采用Mann-Whitney检验比较三甲医院与非三甲医院的差异。
结果：共收集了475份问卷，383家来自顶级三级医院（3A医院），92家来自非顶级三级医院（3A医院除外）。共有240名临床医生，TDM药剂师，临床检验医生也参与其中，有效率为50.5%。顶级三级医院具有某些优势，例如TDM测试设施的数量，年度样本量，监测品种数量，和监测报告的解释率，与非顶级三级医院相比。特别是,β-内酰胺酶抑制剂,奥氮平,卡马西平,糖皮质激素似乎是临床医生想要评估的主要项目.通常进行TDM的药物包括万古霉素，丙戊酸,卡马西平,苯妥英钠，和甲氨蝶呤.最常用的检测方法包括高效液相色谱法，免疫接种,2D-LC,和LC-MS发现大多数药物的监测浓度范围不一致。目前,中国没有统一的TDM收费规定，一般不超过200日元。临床医生依靠药剂师进行专业指导。重要的是,改进监测报告的解释，能力测试,与临床部门的合作可能有助于提高TDM服务水平。
结论:本次调查客观反映了我国医院TDM工作的现状,并为制定改进和有效执行TDM工作的策略提供了强有力的参考基础。
