Doctors' perspectives towards a bedside aminoglycoside therapeutic drug monitoring service: a collaboration between pharmacy and clinical pharmacology

Background:Acomputerised area-under-the-curve aminoglycoside therapeutic drug monitoring (A-TDM) and dosing service was implemented at Flinders Medical Centre. Aim: To assess attitudes and perceptions of junior medical officers and A-TDM service providers towards the use and impact of A-TDM. Methods:Anelectronic surveywas sent to juniormedical officers containing questions on: A-TDMawareness, impact on dosing, duration of therapy,minimisationof toxicityandthe effectof provisionof the serviceonknowledge ofTDMprinciples.Todeterminewhether respondents also had generally negative or positive attitudes, we used K-means cluster analysis. A-TDM service providers were also surveyed. Results: From 145 junior medical officers contacted, 49 (33%) responded: 34 interns and 15 residents. The majority of officers provided generally positive responses, with 38 stating that they were aware of A-TDM, 17 that it often assisted in their patient management, 34 that it improved optimal dosing, 22 that it improved duration, 32 that it improved toxicity minimisation and 33 that it improved their understanding of TDM principles. Cluster analysis produced a positive attitudes group (n = 35) and a negative attitudes group (n = 14) with significantly different responses for each of the six questions (p < 0.01 for each), indicating consistently different attitudes towards the service. Twelve of thirteenA-TDMservice providers responded: eightpharmacyand four medical, reporting positive attitudes towardsA-TDM on treatment efficacy (n = 11), dose optimisation (n = 11) and patient safety (n = 12). Conclusion: A significant proportion of respondents were aware of A-TDM principles and demonstrated favourable attitudes towards its use for dose optimisation and for minimising toxicity.