Reimplementation of a therapeutic drug-monitoring program for digoxin significantly decreased the average number of assays requested per patient from 1.41 to 0.73.
RCT (n=207)
Crossover
Does a continuous therapeutic drug monitoring program for digoxin improve audit criteria performance and reduce the number of assays requested per patient?
A continuous therapeutic drug monitoring program for digoxin is warranted to maintain audit criteria performance and reduce unnecessary assay requests.
Absolute Event Rate: 0.73% vs 1.41%
Although numerous utilization reviews of serum digoxin assays have demonstrated the positive impact of therapeutic drug monitoring, to our knowledge, the question of whether the withdrawal of such a program would reverse the effect has not been addressed. The current study employed a prospective, randomized, crossover design to evaluate this question and document the cost savings. There were 196 serum digoxin assays performed in the 207 patients. It was found that a continuous therapeutic drug-monitoring program was warranted since, after its withdrawal, there was a deterioration in audit criteria performance. Reimplementation of the therapeutic drug-monitoring program resulted in a significant decrease in the average number of assays requested per patient (from 1.41 to 0.73) and an improvement in audit criteria performance.
David Wing (Sat,) conducted a rct in Patients receiving serum digoxin assays (n=207). Therapeutic drug monitoring program vs. Withdrawal of the program was evaluated on Average number of assays requested per patient. Reimplementation of a therapeutic drug-monitoring program for digoxin significantly decreased the average number of assays requested per patient from 1.41 to 0.73.