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. 2023 May 17;18(5):e0285717.
doi: 10.1371/journal.pone.0285717. eCollection 2023.

Vancomycin prescribing and therapeutic drug monitoring: Challenges of real clinical practice

Mariam Hantash Abdel Jalil  1 , Rima Ηijazeen  1 , Farah Khaled Abu-Mahfouz  1 , Khawla Abu Hammour  1 , Maria Hasan Matalqah  2 , Jwan Saleh Khaleel Albadaineh  3 , Shrouq Khaled AlOmoush  2 , Montaha Al-Iede  4   5
Affiliations

Vancomycin prescribing and therapeutic drug monitoring: Challenges of real clinical practice

Mariam Hantash Abdel Jalil et al. PLoS One. .

Abstract

Background: Vancomycin prescription and monitoring guidelines have been reported to be poorly followed by various centers.

Aims: Identifying barriers to compliance with vancomycin dosing and therapeutic drug monitoring guidelines (TDM) and possible ways to enhance compliance based on the healthcare providers' (HCPs) perspective.

Methods: A qualitative study based on semi-structured interviews with HCP (physicians, pharmacists, and nurses) was conducted at two Jordanian Teaching Hospitals. Interviews were audio-recorded and analyzed through thematic analysis. The COREQ criteria for qualitative research were utilized to report the study findings.

Results: A total of 34 HCPs were interviewed. HCP perceived several factors as barriers to guideline recommendation compliance. Such factors included negative perception towards prescription guidelines, lack of knowledge regarding TDM guidelines, the hierarchy of medication management, work pressure, and ineffective communication among healthcare providers. Potential strategies to optimize guidelines adaptation included providing HCPs with more training and decision support tools in addition to activating the role of clinical pharmacists.

Conclusions: The main barriers to guideline recommendations uptake were identified. Interventions should address those barriers related to the clinical environment, including enhancing interprofessional communication related to vancomycin prescription and TDM, reducing workload and providing support systems, promoting educational and training programs, in addition to adopting guidelines suitable for the local environment.

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Conflict of interest statement

NO authors have competing interests.

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