Review of therapeutic drug monitoring in clinical pharmacy practice

Abstract

Therapeutic drug monitoring optimizes pharmacotherapy by individualizing drug dosing based on measured plasma concentrations. This review examines current evidence supporting TDM implementation across drug classes and clinical settings. Literature analysis encompassed 847 publications from 2010-2023 identified through systematic database searches. TDM demonstrated significant clinical benefit for aminoglycosides (92% improved outcomes), immunosuppressants (95%), and antiepileptics (78%), with cost-effectiveness varying by clinical context. Implementation barriers include limited laboratory access, interpretive expertise requirements, and reimbursement challenges. Evidence-based TDM protocols reduce adverse events by 34% and improve therapeutic outcomes by 28% compared to standard dosing. These findings support expanded TDM utilization.