PubMed · 15229468
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
Reynold Spector. 2004. Optimizing drug therapy.. https://doi.org/10.1016/j.clpt.2004.01.018
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Molecular monitoring for patients with chronic myeloid leukaemia (CML) has become an important practice in the era of imatinib therapy. For successful widespread introduction into the mainstream patient monitoring schedule, many procedural aspects of the complex real-time quantitative polymerase chain reaction (RQ-PCR) technique for measuring BCR-ABL transcripts require optimization. Recommendations for harmonizing the differing methodologies have recently been proposed. These recommendations were designed to maximize reliability of analysis for clinical decision making and proposed the adoption of an International Scale of measurement. The purpose of this review is to present the evidence and supporting data for specific recommendations. These recommendations include use of the same source of cells, either blood or marrow, for analysis; for validation of equal PCR amplification efficiencies of cDNA and standards when using a plasmid to construct standard curves and for ensuring ongoing high-level performance by undertaking a quality assurance programme. Clinicians must know the measurement reliability of an RQ-PCR assay to be able to determine the significance of a change in BCR-ABL level. An assay with poor precision limits the clinical usefulness of results. International harmonization should establish RQ-PCR measurement of BCR-ABL as the best method for monitoring treatment response for patients with CML.
In psychiatry, therapeutic drug monitoring (TDM) is an established procedure for most psychotropic drugs. However, as its use in everyday clinical practice is far from optimal, the AGNP-TDM group has worked out consensus guidelines to assist psychiatrists and laboratories involved in drug analysis. Based on a thorough analysis of available literature, 5 levels of recommendation were defined with regard to TDM of psychoactive drugs, from 1) (strongly recommended) to 5) (not recommended). A list of indications for TDM, alone or in combination with pharmacogenetic tests is presented. Instructions are given with regard to preparation of TDM, analytical procedures, reporting and interpretation of results and the use of information for patient treatment. Using the consensus guideline will help to ensure optimal clinical benefit of TDM.
OBJECTIVE: To analyse the degree of monitoring by doctors, nurses, and other health professionals of patients taking psychotropic medication. DESIGN. Retrospective, observational study of patients of both sexes and over 15 years old, who took psychotropic medication and had attended a minimum of ten times the same doctor-nurse primary care unit (PCU). Their monitoring during 2 year-long periods was studied: a first period (the first year after diagnosis) and a second period from October 2001 to October 2002. SETTING: Primary care in the Raval Sud District, Barcelona, Spain. PARTICIPANTS: A total of 730 clinical histories were reviewed, of which 200 (27%) met inclusion criteria. RESULTS: The most common diagnosis was anxiety-depression disorder (58%), and 14.5% of patients had no recorded diagnosis. 35.5% were patients taking more than one medicine. The most common drug group was the benzodiazepines (60.4%). Significant differences in the number of controls were found between the 2 periods and between different PCUs. The mean difference between periods was -0.5, with 95% CI at -1.0: clearly the degree of monitoring drops over time. CONCLUSIONS: These patients' follow-up was not monitored well, which poses the need to create clear aims and protocols for the doctor-nurse team, to thus assist the treatment of patients with mental health problems.