Integration of population kinetic software in clinical practice : an assessment

Abstract

The availability of software packages for the estimation of population kinetics permits the rapid determination of appropriate individualised drug dosing using sparse data. Although the use of these packages is well established in clinical trials, their use in actual clinical practice has been inconsistent, primarily due to prescribers' reluctance to accept these novel programmes and persistent practice of using target serum concentrations as therapeutic endpoints and decision thresholds. In this study the predictive powers and advantages of a commercial software kinetic package in clinical situations was evaluated in two patient populations: ambulatory patients on anti-convulsant therapy (phenytoin) and hospitalised geriatric patients on digoxin. This package, which was based on bayesian estimation and able to handle complex multidose regimens, fitting of clinical data and simulations. Physicians were asked to input the patient-specific characteristics, such as pathophysiological variables and concomitant therapy, demographic data and laboratory data. [excerpt]