The clinical-pharmacological TDM report

To access the full information contained in a blood concentration of a drug it is necessary to take into account all pharmacokinetic and marketing characteristics not only of the drug determined but also of all drugs in the patient's comedication. It cannot be expected that a bedside physician discovers all the information contained in a quantified drug concentration himself. Therefore, a TDM laboratory should never just return the plain concentration and leave it up to the physician to draw the proper conclusions by her- or himself. Nevertheless the determination of a drug concentration is still very often handled like a regular parameter in clinical chemistry. Instead, clinical pharmacological expert interpretations should be rather added to the measured value in a clinical pharmacological report. Such a report has to address drug-drug-interactions, interactions with food components, consumer habits like smoke, alcohol and/or caffeine consumption, genetic as well as age and/or disease dependent abnormalities of drug metabolism, and possible non-compliance. Based on the clinical status of the patient, on treatment and TDM guidelines as well as on the pharmacological data bases the report will also include recommendations such as dose adaptation or changes of the (co)medication.

The internet platform KONBEST supports clinical pharmacological experts in setting up the clinical pharmacological TDM report. Some parts of the report are created automatically, for other parts text sequences are suggested to the clinical pharmacologist who has to choose one and adapt it to the particular case. A third part of the report cannot be created by the computer at all; it has to be entered individually via the clipboard into KONBEST. Finally KONBEST creates a pdf-file that is sent back to the treating physician as laboratory result report.