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Utilization of antipsychotic therapeutic drug monitoring at a state psychiatric hospital
| Content Provider | Semantic Scholar |
|---|---|
| Author | Wong, Kara R. Nelson, Leigh Anne Elliott, Ellie S. R. Liu, Yifei Sommi, Roger W. Winans, Elizabeth A. |
| Copyright Year | 2016 |
| Abstract | Introduction This study assesses the utilization of antipsychotic therapeutic drug monitoring (TDM) and describes characteristics of appropriate and inappropriate TDM at a state psychiatric hospital. Methods A retrospective, descriptive review was conducted for antipsychotic TDM completed between December 1, 2009, and June 30, 2011, at a 65-bed adult inpatient extended-care and forensic state psychiatric hospital. Results One hundred thirty-three (n = 133) antipsychotic serum levels were collected from 44 patients during the study period. Sixty-nine percent (69%) of the TDM were deemed inappropriate, 28% were appropriate, and 3% could not be designated appropriate or inappropriate owing to the lack of information regarding steady-state conditions. The primary reason for inappropriate TDM was lack of documentation with regard to the indication for TDM (n = 79, 59.3%), the intervention following laboratory analysis (n = 88, 66%), or both. Appropriate TDM was associated with a lower laboratory cost for antipsychotic serum level ($48.98 ± $53.49 versus $72.06 ± $51.02, P < .05), lower daily cost of scheduled psychiatric medications ($17.72 ± $23.03 versus $32.26 ± $31.05, P < .05), lower daily cost of total medications ($19.28 ± $24.91 versus $33.82 ± $31.03, P < .05), fewer scheduled psychiatric medications (2.95 ± 1.90 versus 4.04 ± 2.19, P < .01), and fewer total scheduled medications (5.95 ± 3.60 versus 7.60 ± 3.29, P < .05). Inappropriate TDM led to approximately $6,753 in avoidable laboratory costs over a 20-month period. Discussion Therapeutic drug monitoring is a complex process with many points at which errors may occur. The majority of antipsychotic levels at this state psychiatric hospital were not documented in a way that was clinically useful. Inappropriate TDM was associated with increased laboratory and medication costs. |
| Starting Page | 1 |
| Ending Page | 7 |
| Page Count | 7 |
| File Format | PDF HTM / HTML |
| PubMed reference number | 29955441v1 |
| Alternate Webpage(s) | https://doi.org/10.9740/mhc.2016.01.001 |
| DOI | 10.9740/mhc.2016.01.001 |
| Journal | The mental health clinician |
| Volume Number | 6 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Description Document completion status - Documented Inappropriate ADH Syndrome Patients Psychiatric hospital Schedule (document type) Sixty Nine Therapeutic Drug Monitoring inpatient |
| Content Type | Text |
| Resource Type | Article |
