Advances in Pharmacoepidemiology and Drug Safety

Abstract

Optimal Sampling Times for Therapeutic Drug Monitoring

Aize Franciscus van der Meerm and Cees Neef

Therapeutic drug monitoring has evolved from simple concentration measurements to estimating the level of exposure of to the drug and making dosage recommendations. Optimal sampling strategies are commonly used in therapeutic drug monitoring to optimize drug therapy. Optimal sampling strategies aim to determine the sampling times which will produce the most accurate estimation of pharmacokinetic parameters or exposure indices. The methodology used to create optimal sampling strategies is diverse and heterogeneous. Multiple regression analysis has been surpassed by Maximum A Posteriori Bayesian (MAPB) estimation in terms of accuracy and flexibility. An optimal sampling strategy using MAPB estimation is created by either selecting sampling times from a predetermined set of sampling times or using Fisher information to calculate times with the most information on the parameters to be estimated. Validation of the strategy is required, preferably by resampling statistics for its efficient use of data.