Benchmarking therapeutic drug monitoring software: A review of available computer tools

Details

Serval ID
serval:BIB_05B9B2586135
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
Benchmarking therapeutic drug monitoring software: A review of available computer tools
Journal
Clinical Pharmacokinetics
Author(s)
Fuchs A., Csajka C., Thoma Y., Buclin T., Widmer N.
ISSN
0312-5963 (Electronic)
ISSN-L
0312-5963
Publication state
Published
Issued date
2013
Peer-reviewed
Oui
Volume
52
Number
1
Pages
9-22
Language
english
Notes
pdf: REVIEW ARTICLE
Abstract
Therapeutic drug monitoring (TDM) aims to optimize treatments by individualizing dosage regimens based on the measurement of blood concentrations. Dosage individualization to maintain concentrations within a target range requires pharmacokinetic and clinical capabilities. Bayesian calculations currently represent the gold standard TDM approach but require computation assistance. In recent decades computer programs have been developed to assist clinicians in this assignment. The aim of this survey was to assess and compare computer tools designed to support TDM clinical activities. The literature and the Internet were searched to identify software. All programs were tested on personal computers. Each program was scored against a standardized grid covering pharmacokinetic relevance, user friendliness, computing aspects, interfacing and storage. A weighting factor was applied to each criterion of the grid to account for its relative importance. To assess the robustness of the software, six representative clinical vignettes were processed through each of them. Altogether, 12 software tools were identified, tested and ranked, representing a comprehensive review of the available software. Numbers of drugs handled by the software vary widely (from two to 180), and eight programs offer users the possibility of adding new drug models based on population pharmacokinetic analyses. Bayesian computation to predict dosage adaptation from blood concentration (a posteriori adjustment) is performed by ten tools, while nine are also able to propose a priori dosage regimens, based only on individual patient covariates such as age, sex and bodyweight. Among those applying Bayesian calculation, MM-USC*PACK© uses the non-parametric approach. The top two programs emerging from this benchmark were MwPharm© and TCIWorks. Most other programs evaluated had good potential while being less sophisticated or less user friendly. Programs vary in complexity and might not fit all healthcare settings. Each software tool must therefore be regarded with respect to the individual needs of hospitals or clinicians. Programs should be easy and fast for routine activities, including for non-experienced users. Computer-assisted TDM is gaining growing interest and should further improve, especially in terms of information system interfacing, user friendliness, data storage capability and report generation.
Keywords
Therapeutic drug monitoring, Pharmacokinetics, Drug concentration measurement, Dosage individualization, Medical informatics, Computer assisted decision-making, Bayesian prediction, Information storage and retrieval, Systems integration
Pubmed
Web of science
Create date
28/08/2012 14:02
Last modification date
20/08/2019 13:27
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