A cross sectional knowledge attitude practice study on therapeutic drug monitoring among health care professionals in a tertiary care hospital

Abstract

Background: Therapeutic drug monitoring (TDM) is used to optimize drug’s therapeutic effect. Aim of this study is to assess the knowledge, attitude and practice of TDM in health care professionals.Methods: This was a questionnaire-based cross-sectional study. Questionnaires were distributed to 610 nursing staff and 20 lab technicians. Questionnaires had queries on demography, knowledge, attitude and practice. Descriptive statistics and Pearson correlation were used to analyse the data.Results: Among nurses, 7% had good, 60.9% had   fair and 32.2% had poor knowledge of TDM. Among lab technicians 18.2% had good and 81.8% had fair knowledge on TDM. 79.3% of nurses and all lab technicians had favourable attitude towards TDM. Weak positive correlation is seen between knowledge and attitude among nurses. 15.9% of nurses have sent request for TDM on phenytoin, sodium valproate, carbamazepine, methotrexate, lithium, clozapine, risperidone, tigecycline, vancomycin, gentamicin, digoxin and amiodarone. 100% lab technicians have estimated levels of methotrexate and lithium drug sample during the last one year.Conclusions: Though knowledge on indication and pharmacological basis of TDM is lacking among participants, their knowledge on sample collection and sample type is good. They have a positive attitude towards TDM. Nurses have requested TDM for only 12 drugs. TDM of only two drugs was done by lab technicians. Future training should focus on pharmacological basis, selection of appropriate drug candidate and indication for TDM service. TDM service should be made available in all tertiary care institutions.