A cross-sectional study on perceptions and barriers regarding therapeutic drug monitoring services in a tertiary care hospital

The study aimed to assess clinicians’ perceptions regarding therapeutic drug monitoring (TDM), including perceived need, lacunae, extent of utilization, and barriers to TDM services in a tertiary care teaching hospital in Nagpur. We conducted a cross-sectional, questionnaire-based study among clinicians directly involved in patient care after obtaining institutional ethics committee approval. Clinicians were approached to obtain written or electronic consent. The questionnaire consisted of 18 structured, close-ended questions. Responses were collected using a three-point Likert scale, yes/no, or multiple-choice questions. The questionnaire demonstrated good reliability, with a Cohen’s kappa index of 0.7, a scale-level content validity index of 0.82, and a Pearson’s r value of 0.9 on test–retest reliability. The study included 75 clinicians. Among the total participants, only 36% ( n = 27) reported prior use of TDM services in clinical practice; 93.33% ( n = 70) agreed that TDM can be used to optimize drug exposure, and 96% ( n = 72) agreed that pharmacokinetic parameters are affected by concomitant medications and that TDM may prevent adverse drug reaction (ADR). Overall, 56% ( n = 42/75) reported a moderate level of awareness regarding TDM. Major barriers included limited awareness among clinicians (58.66%, n = 44), lack of practical experience (68%, n = 51), and lack of facilities (60%, n = 45). The findings of the present study highlight the need for the implementation of TDM services. While awareness regarding the role of TDM in optimizing drug exposure and preventing ADRs was high, important gaps were noted in the utilization of services, highlighting the need to facilitate education for healthcare professionals and to develop clear, evidence-based clinical guidelines to overcome the observed gaps.