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Verantwoording en kosteneffectiviet van therapeutic drug monitoring (1): Betere behandeling voor minder geld
- Source :
- Pharmaceutisch Weekblad, 138(30), 1061-1066. Kon. Ned. Mij. ter Bevordering der Pharmacie (KNMP)
- Publication Year :
- 2003
-
Abstract
- There are a number of effective but highly toxic drugs that exhibit a narrow therapeutic index and marked intersubject pharmacokinetic variability. Optimal therapy with such drugs requires therapeutic drug monitoring (TDM) in order to safely obtain the desired clinical effects. A systematic review was carried out to document the cost-effectiveness of TDM. The Cochrane database and Medline were searched. Reference lists of articles found were searched manually for relevant articles. Very few studies are performed that document the cost-effectiveness of TDM. Only for aminoglycosides it has been demonstrated that TDM is cost-effective. For the other classes of TDM drugs, its rationale has been made plausible, but cost-effectiveness has not been investigated. Since the use of many of these drugs would contain risks of underdosing or overdosing without TDM, emphasis should not be placed on its cost-effectiveness, but rather on how to use it in the most cost-effective and clinically effective manner possible.
- Subjects :
- topiramate
drug safety
side effect
gabapentin
anticonvulsive agent
vancomycin
oxcarbazepine
phenobarbital
primidone
valproic acid
antibiotic agent
human
felbamate
drug monitoring
cost effectiveness analysis
nephrotoxicity
phenytoin
article
health care cost
risk assessment
aminoglycoside antibiotic agent
tiagabine
drug efficacy
drug overdose
ototoxicity
health care quality
carbamazepine
drug blood level
lamotrigine
zonisamide
vigabatrin
Subjects
Details
- Language :
- Dutch; Flemish
- ISSN :
- 00316911
- Database :
- OpenAIRE
- Journal :
- Pharmaceutisch Weekblad, 138(30), 1061-1066. Kon. Ned. Mij. ter Bevordering der Pharmacie (KNMP)
- Accession number :
- edsair.narcis........c252783b0d7c4bd42711c993c40650e0