Individualised medicine: why we need Bayesian dosing

被引:40
作者
Donagher, Joni [1 ]
Martin, Jennifer H. [2 ]
Barras, Michael A. [3 ,4 ]
机构
[1] Royal North Shore Hosp, Dept Pharm, Sydney, NSW, Australia
[2] Univ Newcastle, Discipline Clin Pharmacol, Sch Med & Publ Hlth, Newcastle, NSW, Australia
[3] Univ Queensland, Sch Pharm, Brisbane, Qld, Australia
[4] Princess Alexandra Hosp, Pharm Dept, Brisbane, Qld, Australia
关键词
individualised drug dosing; Bayesian; DRUG; GUIDELINES; TOBRAMYCIN;
D O I
10.1111/imj.13412
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Individualised drug dosing has been shown to improve patient outcomes and reduce adverse drug events. One method of individualised medicine is the Bayesian approach, which uses prior information about how the population responds to therapy, to inform clinicians about how a specific individual is responding to their current therapy. This information is then used to make changes to the dose. Studies using a Bayesian approach to adjust drug dosing have shown that clinicians are able to achieve a therapeutic range quicker than standard practice. If concentration is related to a pharmacodynamic end-point, this means that the drug will be more effective, and the side-effects will be minimised. Unfortunately, the software options to assist with Bayesian dosing in Australia are limited. The aims of this article are to demystify the concepts of Bayesian dosing, set the context of the Bayesian approach using reference to other dosing strategies and discuss its benefits over current dosing methods for a number of drugs. The article is targeted to medical and pharmacy clinicians, and there is a practical clinical case to demonstrate how this method could be used in everyday clinical practice.
引用
收藏
页码:593 / 600
页数:8
相关论文
共 26 条
  • [11] Ette EI, 2006, PHARMACOMETRICS SCI
  • [12] Conventional compared with individualized chemotherapy for childhood acute lymphoblastic leukemia
    Evans, WE
    Relling, MV
    Rodman, JH
    Crom, WR
    Boyett, JM
    Pui, CH
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1998, 338 (08) : 499 - 505
  • [13] Benchmarking Therapeutic Drug Monitoring Software: A Review of Available Computer Tools
    Fuchs, Aline
    Csajka, Chantal
    Thoma, Yann
    Buclin, Thierry
    Widmer, Nicolas
    [J]. CLINICAL PHARMACOKINETICS, 2013, 52 (01) : 9 - 22
  • [14] Dosing strategy for enoxaparin in patients with renal impairment presenting with acute coronary syndromes
    Green, B
    Greenwood, M
    Saltissi, D
    Westhuyzen, J
    Kluver, L
    Rowell, J
    Atherton, J
    [J]. BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2005, 59 (03) : 281 - 290
  • [15] Target concentration intervention is needed for tobramycin dosing in paediatric patients with cystic fibrosis - a population pharmacokinetic study
    Hennig, Stefanie
    Norris, Ross
    Kirkpatrick, Carl M. J.
    [J]. BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2008, 65 (04) : 502 - 510
  • [16] Comparing Dosage Adjustment Methods for Once-Daily Tobramycin in Paediatric and Adolescent Patients with Cystic Fibrosis
    Hennig, Stefanie
    Holthouse, Franziska
    Staatz, Christine E.
    [J]. CLINICAL PHARMACOKINETICS, 2015, 54 (04) : 409 - 421
  • [17] Individualized mycophenolate mofetil dosing based on drug exposure significantly improves patient outcomes after renal transplantation
    Le Meur, Y.
    Buechler, M.
    Thierry, A.
    Caillard, S.
    Villemain, F.
    Lavaud, S.
    Etienne, I.
    Westeel, P.-F.
    de Ligny, B. H.
    Rostaing, L.
    Thervet, E.
    Szelag, J. C.
    Rerolle, J.-P.
    Rousseau, A.
    Touchard, G.
    Marquet, P.
    [J]. AMERICAN JOURNAL OF TRANSPLANTATION, 2007, 7 (11) : 2496 - 2503
  • [18] Lucas C, 2013, AUST FAM PHYSICIAN, V42, P18
  • [19] Variability in Response to Medicines in Older People: Phenotypic and Genotypic Factors
    McLachlan, A. J.
    Hilmer, S. N.
    Le Couteur, D. G.
    [J]. CLINICAL PHARMACOLOGY & THERAPEUTICS, 2009, 85 (04) : 431 - 433
  • [20] Current Status of Therapeutic Drug Monitoring in Australia and New Zealand: A Need for Improved Assay Evaluation, Best Practice Guidelines, and Professional Development
    Norris, Ross L.
    Martin, Jennifer H.
    Thompson, Erin
    Ray, John E.
    Fullinfaw, Robert O.
    Joyce, David
    Barras, Michael
    Jones, Graham R.
    Morris, Raymond G.
    [J]. THERAPEUTIC DRUG MONITORING, 2010, 32 (05) : 615 - 623