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Table 2 Identified barriers and facilitators influencing the implementation of therapeutic drug monitoring for ICU patients (n = 64)

From: Barriers and facilitators for therapeutic drug monitoring of beta-lactams and ciprofloxacin in the ICU: a nationwide cross-sectional study

Factors

Barriers

Beta-lactams (%)

Ciprofloxacin (%)

Procedure

I don’t have all the information and materials required to perform TDM

39

47

 

I don’t have sufficient knowledge to use TDM

23

30

 

I don’t have sufficient practical experience to use TDM

28

36

 

For TDM, I am not aware of the activities I should perform and in which order

 

28

 

Little experience with dose individualization TDM hinders me from using it

 

27

 

The outcomes of using TDM are not clearly observable to me

 

20

Beliefs

The use of TDM does not saves costs

36

38

 

I don’t believe dose individualization of TDM is cost-effective

20

22

 

TDM increases my workload

30

25

 

Colleagues don’t expect me to apply TDM

 

25

 

TDM does not shorten ICU length of stay

 

20

Organization

There are no formal arrangements relating to the use of TDM

55

72

 

There are other changes going on that influence implementation of TDM

36

39

 

In my organization, no one have been designated to coordinate the process of implementing TDM

28

39

Literature

The lack of evidence on the effectiveness of TDM hinders me from using it

53

58

 

The lack of evidence on the cost-effectiveness of TDM hinders me from using it

31

30

 

Facilitators

  

Procedure

The use of TDM to treat infections

92

 

Beliefs

I feel it is my responsibility as a professional to use TDM

84

 
 

TDM is not too complex for me to use

81

 
 

TDM prevents side effects

81

 
  1. Data expressed as percentages representing the fraction of respondents that indicated that that the statement was a barrier or facilitator. The results of all questions are found in Additional file 1: Table S1
  2. TDM therapeutic drug monitoring, ICU intensive care unit