Monitoring XXXX 's @entity137 : recommendations, evidence, and clinical practice.

@entity1 @entity2643 @entity137
OBJECTIVES: We sought to develop an explicit evidence-based model of medication monitoring and to evaluate monitoring practices and adverse drug events in @entity1 taking @entity2643 at one institution. METHODS: We searched MEDLINE (1966 through 2000) for English-language publications providing specific monitoring recommendations for @entity2643 . A cross-sectional retrospective chart review of 99 outpatients receiving @entity2643 therapy between Jan 1, 2000, and Jan 1, 2001, at a large tertiary-care hospital was performed to assess monitoring practices. Adverse drug events were identified by use of structured implicit reviews. The main outcome measure was the proportion of @entity1 receiving the monitoring recommended in the literature and having @entity2643 -related adverse drug events. RESULTS: Forty-three articles were identified that provided specific monitoring recommendations, although no studies were found that compared the outcomes of @entity1 managed with different monitoring regimens. Overall, 70% of the recommended monitoring criteria were satisfied, although only 9 @entity1 (9%; 95% confidence interval [95% CI], 3%-15%) received all of the recommended monitoring. Variability in monitoring practices was identified at all stages of the monitoring model. Of the @entity1 , 52 (52%; 95% CI, 42%-62%) received minimum baseline evaluations, 22 (22%; 95% CI, 14%-31%) underwent ongoing surveillance, 75 (75%; 95% CI, 61%-89%) had appropriate responses to abnormal surveillance results, and 71 (71%; 95% CI, 62%-80%) had timely follow-up visits. Of the @entity1 , 8 (8%; 95% CI, 3%-13%) had 9 @entity2643 -related adverse drug events, of which 3 were judged to be preventable. Interrater agreement for monitoring processes (kappa = 0.83) and adverse drug events (kappa = 0.67) was good. CONCLUSIONS: Current standards for @entity2643 @entity137 monitoring are based on expert opinion with limited evidence to support most recommendations. Monitoring practices appear to vary significantly, with few @entity1 receiving all of the recommended monitoring. Some @entity2643 -related adverse drug events may be preventable and @entity1 safety might be improved with a better understanding of monitoring processes.
