Study design (if review, criteria of inclusion for studies)
retrospective cohort study
40 CF patients
Managed therapeutic drug monitoring (TDM) by clinical pharmacist (CP) compared with usual care (UC).
Clinical pharmacist impact on care, length of stay, and cost in pediatric cystic fibrosis (CF) patients. Number of pediatric CF patients achieving Aminoglicoside (AG) pharmacokinetic and pharmacodynamic (PK/PD) targets when a clinical pharmacist (CP) managed therapeutic drug monitoring (TDM) compared with usual care (UC).
Twenty-nine patients with 52 courses of AGs were included the CP group, and 22 patients with 42 courses were included the UC group. Ninety-eight percent of patients in the CP group reached AG PK/PD targets compared with 71% in the UC group, Pâ<â0.001. Patients in the CP group reached the AG PK/PD target in a mean of 1.9âÂ±â0.8 days compared with 4.8âÂ±â3.4 days in the UC group, Pâ<â0.0001. The average LOS in the CP group was 9âÂ±â5 days compared with 12âÂ±â7.5 days in the UC group, Pâ=â0.033. The mean number of levels per patient was 2.7 in the CP group compared with 5.2 (range of 2-20) in the UC group, Pâ<â0.001. Resource utilization associated with drug levels, dosing adjustments and LOS were $26,549, $14,069, and $1,680,000 in the CP group as compared with $40,683, $27,812, and $1,940,000, respectively, in the UC group.
CP managed TDM resulted in a significantly higher percentage of pediatric CF patients achieving AG PK/PD targets 3 days sooner with an average LOS that was 3 days shorter. CP managed TDM resulted in significantly fewer dosage adjustments, drug levels, and cost associated with serum sampling, drug wastage, and LOS.