Mapping the clinical pharmacokinetics and pharmacogenetic units operating in Spanish hospitals

Abstract

ObjectiveThe goal of this article is to analyze the situation of pharmacokinetics and pharmacogenetics units in the pharmacy departments of Spanish hospitals, evaluate their development both in the clinical and educational areas, and draw up a map reflecting their current status. MethodA 29-item survey structured in five blocks was designed with general questions about the respondents’ hospital and the clinical and educational activities carried out by their pharmacy department, in the fields of both pharmacokinetics and pharmacogenetics. ResultsSixty-nine hospitals answered the survey. The highest response rates corresponded to Catalonia, the Valencia region and Andalusia. The drug families subject to closest monitoring were classic antibiotics (93%), digoxin (57%), classic antiepileptics (51%) and biologicals (43%). The most frequently used computer programs included PKS and NONMEM (93% and 22% of hospitals, respectively). Regarding training in pharmacokinetics, second year residents were those who most frequently rotated through the pharmacokinetics unit (40%), while 44% of those units allowed external residents. As far as pharmacogenetics is concerned, in 42% of hospitals that engaged in pharmacogenetic work, the department in charge was pharmacy. The most frequent specialties covered were hemato-oncology (72%) and psychiatry (15%). Twenty-four percent of hospitals offered rotations through their pharmacogenetics unit but only seven of them allowed external residents. ConclusionsThe results of the survey showed an increase in the performance of pharmacokinetic and pharmacogenetic activities by Spanish hospital pharmacies as compared with the data from a 2009 baseline survey, with many hospitals introducing the performance of therapeutic drug monitoring of non-classical antibiotics, immunosuppressants and biologies. However, the percentage of hospitals that follow the ideal model based on analytical determinations and pharmacokinetic reporting has decreased the data obtained served as a basis to create an updated map of the pharmacokinetics and pharmacogenetics units operating in Spanish hospital pharmacy departments. This map, available at http://bit.ly/mapaPKGen, will be very useful to facilitate the training of residents in these disciplines and will help promote the development of pharmacokinetic and pharmacogenetic activities among hospital pharmacists.