Therapeutic drug monitoring survey
Purpose
The purpose of this survay is to map and characterise the therapeutic drug monitoring (TDM) services provided by clinical pharmacy in UK
Instruction
The survey consists of tick box questions about various possible TDM services. Please asses general relevance, place in current service and potential further development for each of the listed service features in the survey. Try to answer all questions fully, even though some services may not be relevant to your practice Completion of this survey is voluntary. By submitting the webquestionnaire you consent to participate in this project. Your response is anonymous.
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Therapeutic drug monitoring survey
Step 1 of (of ): Demography
D1 Demography How many years have you been on the pharmacists register (ie. the number of years as a pharmacist)?

less than 3 years

3-5 years

6-10 years

more than 10 years

D2 Demography How long have you been working as clinical pharmacist?

less than 3 years

3-5 years

6-10 years

more than 10 years

 D3 Demography   How long have you been providing TDM services to your present unit?

less than 3 years

3-5 years

6-10 years

more than 10 years

D4 Demography Which is the highest postgraduate qualification you hold?

none

Postgraduated diploma in clinical pharmacy

MSc in clinical pharmacy

MPhil/PhD

other
D5 Demography Which of the following best describes your unit ?

Surgical

Medical

Neuro

Cardiac

General adults

Neonatals/Paediatrics

Out patient clinic

D6 Demography In which area of UK do you practice

Scotland

Northem Ireland

Wales

Enghland (Londone & South East)

Enghland midlands

North Enghland

West Enghland

East Enghland

South Enghland

D7 Demography Are you supplementary prescriber?

Yes

No
D8 Demography Please indicate what formal TDM training you have received:
Clinical pharmacy and Therapeutic drug monitoring survey
Step 2 (of ): Indication to request of drug levels
The following potiential features of therapeutic drug monitoring services have been generated by literature review and interviews with practitioners. please respond to each item to indecate your assessment of:

• Relevance to TDM services (Low, Medium,High)
• Place of the feature in the current delivery of your service (Not included, Included, Core component)
• Priority for further development (Low, Medium, Hight)
     
Q1 Request the drug level in context of appropriate indication, toxicity, patient compliance, clinical response, and change in clinical state
Q1(a) Relevance to TDM services

High

Medium

Low
Q1(b) Place of the feature in the current delivery of your service

Not included

Included

Core component
Q1(c) Priority for further development

High

Medium

Low
     
Q2 Evaluate and warrant the request for drug assay by one of the professional medical staff before performing of the assays
Q2(a) Relevance to TDM services

High

Medium

Low
Q2(b) Place of the feature in the current delivery of your service

Not included

Included

Core component
Q2(c) Priority for further development

High

Medium

Low
     
Steps 3 (of ) The drug assay request
Q3 Provide the request with important information for sensible interpretation of the results
Q3(a) Relevance to TDM services

High

Medium

Low
Q3(b) Place of the feature in the current delivery of your service

Not included

Included

Core component
Q3(c) Priority for further development

High

Medium

Low
     
Q4 Provide the request with:
    AllAlleywayes Sometimes Never
Q4(a) Time of the sample taken
Q4(b) Time of the administration
Q4(c) History of the administered
Q4(d) Any co-medications
Q4(e) The demographics of the patient
Q4(f) The indication for the request
Q4(g) The need for a rapid feedback of the results
         
Q5 Provide a computer system to write order directly on-line
Q5(a) Relevance to TDM services

High

Medium

Low
Q5(b) Place of the feature in the current delivery of your service

Not included

Included

Core component
Q5(c) Priority for further development

High

Medium

Low
     
Step 4 (of ) Requested biological sample
     
Q6 Collect the sample at specific time to provide a clinical meaningful measurement
Q6(a) Relevance to TDM services

High

Medium

Low
Q6(b) Place of the feature in the current delivery of your service

Not included

Included

Core component
Q6(c) Priority for further development

High

Medium

Low
     
Q7 Chose an appropriate matrix for monitoring of drug concentrations
Q7(a) Relevance to TDM services

High

Medium

Low
Q7(b) Place of the feature in the current delivery of your service

Not included

Included

Core component
Q7(c) Priority for further development

High

Medium

Low
     
Q8 Use appropriate container, compatible with sample types and drugs that going to be assayed
Q8(a) Relevance to TDM services

High

Medium

Low
Q8(b) Place of the feature in the current delivery of your service

Not included

Included

Core component
Q8(c) Priority for further development

High

Medium

Low
     
Step 5 (of ): Laboratory measurements
     
Q9 Perform the assay within a clinically useful time frame
Q9(a) Relevance to TDM services

High

Medium

Low
Q9(b) Place of the feature in the current delivery of your service

Not included

Included

Core component
Q9(c) Priority for further development

High

Medium

Low
     
Q10 Ensure the accuracy of the results obtained from the laboratory
Q10(a) Relevance to TDM services

High

Medium

Low
Q10(b) Place of the feature in the current delivery of your service

Not included

Included

Core component
Q10(c) Priority for further development

High

Medium

Low
     
Q11 Accuracy consideration relevent to TDM service
    Low Medium High
Q11(a) The laboratory is accredited
Q11(b) The laboratory is inspected randomly
Q11(c) The assay performance is evaluated by using external quality assurance program and by internal quality control.
Q11(d) Laboratory have a certain procedure to obtain any useful information missed from drug assay request
Q11(e) Each analytical run is performed with appropriate number of calibration standards and quality controls
Q11(f) The assay result is verified by senior laboratory staff
Q11(g) The accuracy, precision, sensitivity and specificity of each assay is documented and assessed regularly
     
Q12 Consider the rapid and cost-effectiveness measurement of the most drugs
Q12(a) Relevance to TDM services

High

Medium

Low
Q12(b) Place of the feature in the current delivery of your service

Not included

Included

Core component
Q12(c) Priority for further development

High

Medium

Low
     
Q13 Use a quality control material from independent sources
Q13(a) Relevance to TDM services

High

Medium

Low
Q13(b) Place of the feature in the current delivery of your service

Not included

Included

Core component
Q13(c) Priority for further development

High

Medium

Low
     
Advice clinician about the interpretation of complex results
Q14(a) Relevance to TDM services

High

Medium

Low
Q14(b) Place of the feature in the current delivery of your service

Not included

Included

Core component
Q14(c) Priority for further development

High

Medium

Low
     

Organise reliable laboratory information systems to support TDM services