Therapeutic drug monitoring in India: A strength, weakness, opportunity and threats analysis

Author:

Pattanaik Smita1ORCID,Gota Vikram23ORCID,Tripathi Santanu Kumar4ORCID,Kshirsagar Nilima A.56ORCID

Affiliation:

1. Clinical Pharmacology Post Graduate Institute of Medical Education and Research Chandigarh India

2. Advanced Centre for Treatment Education and Research in Cancer Tata Memorial Centre Kharghar Navi Mumbai India

3. Homi Bhabha National Institute Mumbai India

4. Pharmacology Netaji Subhas Medical College and Hospital Patna Bihar India

5. Clinical Pharmacology Indian Council of Medical Research New Delhi India

6. Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital Mumbai India

Abstract

Over the last three to four decades, Therapeutic Drug Monitoring (TDM) has shaped itself as therapeutic drug management, an integral component of precision medicine. The practice of TDM is not extensive in India, despite being one of the fastest‐growing economies in the world. It is currently limited to a few academic medical centres and teaching hospitals. Apart from the immunosuppressive drugs, several other therapeutic areas, such as anticancer, antifungal, antibiotic and antitubercular, have demonstrated great potential to improve patient outcomes in Indian settings. Factors such as the higher prevalence of nutritional deficiencies, tropical diseases, widespread use of alternative medicines, unalike pharmacogenomics and sparse population‐specific data available on therapeutic ranges of several drugs make the population of this subcontinent unique regarding the relevance of TDM. Despite the impact of TDM in clinical science and its widespread application, TDM has failed to receive the attention it deserves in India. This review intends to bring out a strength, weakness, opportunity and threats (SWOT) analysis for TDM in India so that appropriate steps for fostering the growth of TDM could be envisioned. The need of the hour is the creation of a cooperative group including all the stakeholders, such as TDM professionals, clinicians and the government and devising a National Action Plan to strengthen TDM. Nodal TDM centres should be established, and pilot programmes should be rolled out to identify the thrust areas for TDM in the country, capacity building and creating awareness to integrate TDM into mainstream clinical medicine.

Publisher

Wiley

Subject

Pharmacology (medical),Pharmacology

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