Abstract
Background The application of clinical pharmacokinetics (PK) is essential when providing pharmaceutical care. Appropriate application of PK monitoring results in improved patient outcomes including decreased mortality, length of treatment, length of hospital stay, and adverse effects of drug therapy. Despite the well-documented evidence of benefits of clinical PK services, many pharmacists find it challenging to apply PK in clinical practice. Objective To evaluate pharmacists’ training backgrounds, attitude, practices, and perceived barriers pertaining to the application of PK in clinical practice in Qatar. Setting All hospitals under Hamad Medical Corporation, the main healthcare provider in Qatar. Methodology This was a cross-sectional, descriptive study that was conducted between October 2012 and January 2013, using a self-administered web-based survey. Pharmacists were eligible to participate if they: (1) were working as full-time hospital pharmacists and; (2) have been in practice for at least 1 year. Main outcome measures PK contents learned in undergraduate curriculum; perception towards the PK contents and instructions received in the undergraduate curriculum and; application of PK in current clinical practice. Results A total of 112 pharmacists responded to the questionnaire. The majority of the respondents (n = 91; 81.3 %) reported that they had received PK course(s) in their undergraduate curriculum. Similarly, the majority (70–80 %) of them agreed that the undergraduate PK courses or contents they received were important and relevant to their current practice. The pharmacists identified spending more time on dispensing and inventory issues rather than clinical practice, scarce resources, and manual rather than computerized PK calculations as some of the barriers they encountered in learning about PK and its application. The characteristics of the surveyed pharmacists such as gender, age, highest academic degree, and country of graduation did not influence the pharmacists’ perception and attitudes towards PK teaching and application (p > 0.05). Conclusion PK course contents were perceived to lack depth and relevance to practice, and pharmacist had no experiential training that included aspects of PK. These, and other issues, result in poor application of PK in practice.
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References
American Society of Health-System Pharmacists. Statement on the Pharmacist’s Role in Clinical Pharmacokinetic Monitoring. 2013. [13/12/2014]. http://www.ashp.org/DocLibrary/BestPractices/SpecificStPKMonitor.aspx.
Cies JJ, Varlotta L. Clinical pharmacist impact on care, length of stay, and cost in pediatric cystic fibrosis (CF) patients. Pediatr Pulmonol. 2013;48(12):1190–4.
Ensom MH, Davis GA, Cropp CD, Ensom RJ. Clinical pharmacokinetics in the 21st century. Does the evidence support definitive outcomes? Clin Pharmacokinet. 1998;34(4):265–79.
Murphy R, Chionglo M, Dupuis LL. Impact of a pharmacist-initiated therapeutic drug monitoring consult service for children treated with gentamicin. CJHP. 2007;60(3):162–8.
Shenfield GM. Therapeutic drug monitoring beyond 2000. Br J Clin Pharmacol. 1998;46(2):93–4.
Touw DJ, Neef C, Thomson AH, Vinks AA. Cost-effectiveness of therapeutic drug monitoring: a systematic review. Ther Drug Monit. 2005;27(1):10–7.
Vozeh S. Cost-effectiveness of therapeutic drug monitoring. Clin Pharmacokinet. 1987;13(3):131–40.
Aldaz A, Ferriols R, Aumente D, Calvo MV, Farre MR, Garcia B, et al. Pharmacokinetic monitoring of antiepileptic drugs. Farm Hosp. 2011;35(6):326–39.
Naik GS, Kodagali R, Mathew BS, Thomas M, Prabha R, Mathew V, et al. Therapeutic drug monitoring of levetiracetam and lamotrigine: is there a need? Ther Drug Monit. 2015;37(4):437–44.
Patsalos PN, Berry DJ, Bourgeois BF, Cloyd JC, Glauser TA, Johannessen SI, et al. Antiepileptic drugs—best practice guidelines for therapeutic drug monitoring: a position paper by the subcommission on therapeutic drug monitoring, ILAE Commission on Therapeutic. Epilepsia. 2008;49(7):1239–76.
Stepanova D, Beran RG. The benefits of antiepileptic drug (AED) blood level monitoring to complement clinical management of people with epilepsy. Epilepsy Behav. 2015;42:7–9.
Hurley SF, Dziukas LJ, McNeil JJ, Brignell MJ. A randomized controlled clinical trial of pharmacokinetic theophylline dosing. Am Rev Respir Dis. 1986;134(6):1219–24.
Lehmann CR, Leonard RG. Effect of theophylline pharmacokinetic monitoring service on cost and quality of care. Am J Hosp Pharm. 1982;39(10):1656–62.
Duhme DW, Greenbaltt DJ, Koch-Weser J. Reduction of digoxin toxicity associated with measurement of serum levels. A report from the Boston Collaborative Drug Surveillance Program. Ann Intern Med. 1974;80(4):516–9.
Horn JR, Christensen DB, deBlaquiere PA. Evaluation of a digoxin pharmacokinetic monitoring service in a community hospital. Drug Intell Clin Pharm. 1985;19(1):45–52.
Dhillon A, Gill K. Basic pharmacokinetics. (8/8/2013). http://www.dandybooksellers.com/acatalog/9780853695714.pdf.
Jones D. Therapeutic drug monitoring: a vital pharmacy role. BJ Clin Pharm. 2009. (3/1/2015). http://www.clinicalpharmacy.org.uk/volume1_2/June/therapeutics.pdf.
Kheir N, Fahey M. Pharmacy practice in Qatar: challenges and opportunities. South Med Rev. 2011;4(2):92–6.
Zaidan M, Singh R, Wazaify M, Tahaineh L. Physicians’ perceptions, expectations, and experience with pharmacists at Hamad Medical Corporation in Qatar. J Multidiscip Healthc. 2011;4:85–90.
Qatar National Development Strategy 2011–2016: Towards Qatar’s National Vision 2030. 2011. (10/9/2011). http://www.gsdp.gov.qa/gsdp_vision/docs/NDS_EN.pdf.
Murphy JE, Slack MK, Campbell S. National survey of hospital-based pharmacokinetic services. Am J Health Syst Pharm. 1996;53(23):2840–7.
Boynton PM, Greenhalgh T. Selecting, designing, and developing your questionnaire. BMJ. 2004;328(7451):1312–5.
Saw SM, Ng TP. The design and assessment of questionnaires in clinical research. Singap Med J. 2001;42(3):131–5.
Spruill WJ, Wade WE. Curricular and content survey of clinical pharmacokinetics courses. Am J Pharm Educ. 2003;67(2):1–11.
Brackett CC, Reuning RH. Teaching pharmacokinetics using a student-centered, modified mastery-based approach. Am J Pharm Educ. 1999;63:272–7.
Ratanajamit C, Kaewpiba P, Setthawacharavanich S, Faroongsarng D. Effect of pharmacist participation in the health care team on therapeutic drug monitoring utilization for antiepileptic drugs. J Med Assoc Thai. 2009;92(11):1500–7.
Hamzah A, Ab Rahman AF. Evaluation of blood sampling times and indications for therapeutic drug monitoring services. Malay J Pharm Sci. 2008;6(1):1–11.
Kruger J, Dunning D. Unskilled and unaware of it: how difficulties in recognizing one’s own incompetence lead to inflated self-assessments. J Pers Soc Psychol. 1999;77(6):1121–34.
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The authors would like to thank all pharmacists who participated in the validation and piloting of the questionnaire as well as those who responded to the survey.
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The study has received an external funding from the Qatar National Research Fund (QNRF) through its Undergraduate Research Experience Program (UREP). The statements made herein are solely the responsibility of the authors.
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The authors have no competing interests to declare.
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Kheir, N., Awaisu, A., Gad, H. et al. Clinical pharmacokinetics: perceptions of hospital pharmacists in Qatar about how it was taught and how it is applied. Int J Clin Pharm 37, 1180–1187 (2015). https://doi.org/10.1007/s11096-015-0183-3
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DOI: https://doi.org/10.1007/s11096-015-0183-3