After discontinuation of the TDM service, the clinicians appeared to assume that determination of serum gentamicin concentration was appropriately timed with respect to dose administration. Thus, gentamicin dose adjustments were made in 12 instances in this patient group when an appreciation of the impact of the timing of the samples relative to the time of [...]

In this study, pharmacists made appropriate gentamicin dose adjustments in response to serum concentrations of the drug more frequently than physicians (99% and 64%, respectively; p < 0.001). Other similarly designed studies have shown benefit from a pharmacist-initiated TDM consult service. Bollish and others evaluated a pharmacist-based aminoglycoside pharmacokinetic service by assessing the appropriateness of [...]

One hundred and forty-six children, for whom a total of 194 pairs of gentamicin results were available, were included in this study: 72 children (with 94 pairs of results) before discontinuation of the pharmacist- initiated TDM consult service and 74 children (with 100 pairs of results) after discontinuation of the TDM consult service (Table 1).

This study was approved by the Research Ethics Board at The Hospital for Sick Children. A chart review was conducted for patients treated between January 2003 and January 2004, which represented the 6 months before and the 6 months after removal of the pharmacist-initiated TDM consult service (on July 1, 2003). All children admitted to [...]

Less Favourable Results for the Control Groups The 2 control groups (baseline and concurrent) showed less favourable patient outcomes. Physicians performing warfarin dosing for the 2 control groups did not have the benefits of warfarin nomograms, protocols, or specific training. Increased morbidity and mortality were reported (Tables 4 and 8). The higher morbidity and mortality [...]

Previous studies throughout North America have yielded strong evidence that inpatient and outpatient warfarin dosing services and clinics staffed by qualified personnel are associated with better patient outcomes and anticoagulation management. This study was performed to determine whether a pilot project at Providence Healthcare would support a hospital-wide inpatient warfarin dosing service. The goals and [...]

An evaluation of the pilot project was conducted as an open case series. The aim was to enroll 30 patients in the pilot warfarin dosing service over a 5-month study period (October 16, 2003, to March 18, 2004).