Table 1.
Comparison of the drug monitoring parameters reported in the discharge letters with the monitoring recommendations in the corresponding summary of product characteristics.
| Active pharmaceutical substance (frequency)a | Location in the discharge letter (frequency)b | Drug class | Drug monitoring parameter in discharge letter (frequency)c | Drug monitoring parameters in the summary of product characteristics |
| Apixaban (1/8) | TXTd (1) | Factor Xa inhibitor | Blood cell count (1) | Bleeding signs |
| Atorvastatin (3/37) | MEDe (3), TXT (1) | HMG-CoAf-reductase inhibitor | CKg (1), LDLh (3), liver function (1) | CK, liver function test |
| Candesartan (1/20) | MED (1), TXT (1) | Angiotensin-II- receptor antagonist | Blood pressure (1), renal function (1) | Only in special patient populations (hypertension and impaired renal function, heart failure) |
| Carvedilol (1/10) | MED (1), TXT (1) | Nonselective beta blocker | Blood pressure (1), heart rate (1) | Only in special patient populations (heart failure with low blood pressure or ischemic heart disease) |
| Cefuroxime (1/4) | TXT (1) | Cephalosporin | Inflammatory parameters (1) | No parameters mentioned |
| Ciclosporin (2/2) | MED (1), TXT (1) | Calcineurin inhibitor | Blood concentration (2) | Serum potassium, serum magnesium, serum lipids, uric acid, renal function, liver function, ciclosporin concentrations, blood pressure, and physical examination |
| Ciprofloxacin (2/12) | TXT (2) | Fluorquinolone | Inflammatory parameters (2), renal function (1) | No parameters mentioned |
| Clindamycin (1/1) | TXT (1) | Lincosamide | Inflammatory parameters (1) | Blood cell count, liver function test, and renal function test |
| Colecalciferol (1/8) | TXT (1) | Vitamin | Serum calcium (1) | Calcium in serum and urine, creatinine |
| Dabigatran etexilate (1/3) | MED (1) | Thrombin inhibitor | Liver function (1), renal function (1) | Renal function, signs and symptoms of bleeding or anemia |
| Duloxetine (2/3) | TXT (2) | Selective serotonin and norepinephrine reuptake inhibitor | Serum sodium (2) | Only in special patient populations (old patients, hypertension, or heart disease) |
| Enoxaparin (2/36) | TXT (2) | Low-molecular-weight heparin | Blood cell count (2) | Platelet count |
| Eplerenone (1/4) | MED (1) | Mineralocorticoid receptor antagonist | Renal function (1), electrolytes (1) | Serum potassium |
| Furosemide (2/11) | TXT (2) | Loop diuretics | Renal function (1), electrolytes (1), body weight (1) | Potassium, sodium, calcium, bicarbonate, creatinine, blood urea, uric acid, and blood glucose |
| Hydrochlorothiazide (1/14) | MED (1), TXT (1) | Thiazide diuretic | Renal function (1), electrolytes (1), | Serum potassium, serum sodium, and serum magnesium |
| Insulin (6/30) | TXT (6) | Insulin | Blood glucose (6) | Blood glucose |
| Pancreatic enzyme supplement (2/6) | TXT(2) | Enzymes | Stool consistency (2) | No parameters mentioned |
| Levetiracetam (1/8) | TXT (1) | Antiepileptic | Renal function (1) | Suicidal ideation |
| Levothyroxine (5/34) | MED (1), TXT (5) | Thyroid hormone | Thyroid function (5) | No parameters mentioned |
| Nebivolol (1/7) | TXT (1) | Selective beta blocker | Heart rate (1) | No parameters mentioned |
| Oxcarbazepine (1/1) | TXT (1) | Antiepileptic | Serum sodium (1) | Serum sodium, suicidal ideation |
| Phenprocoumon (6/13) | MED (2), TXT (5) | Vitamin K antagonist | INRi (6) | Liver function test, INR |
| Pravastatin (1/16) | MED (1) | HMG-CoA-reductase inhibitor | LDL (1) | Only in special patient population (patients with myopathy, impaired renal function, hypothyroidism, or alcohol abuse) |
| Ramipril (1/44) | MED (1) | Angiotensin-converting-enzyme inhibitor | Blood pressure (1) | Serum potassium, renal function, and leukocytes |
| Sildenafil (1/2) | MED (1) | Phosphodiesterase type 5 inhibitor | Blood pressure (1), heart rate (1) | No parameters mentioned |
| Simvastatin (1/9) | MED (1) | HMG-CoA-reductase inhibitor | LDL (1) | CK, liver function test |
| Spironolactone (2/13) | TXT (2) | Mineralocorticoid receptor antagonist | Renal function (1), electrolytes (1), body weight (1) | Potassium, sodium, calcium, bicarbonate, creatinine, blood urea, uric acid, and acid-base balance |
| Tacrolimus (5/6) | MED (5), TXT (2) | Calcineurin inhibitor | Blood concentration (5) | Electrolytes, liver function, renal function, fasting blood glucose, hematological parameters, coagulation, plasma proteins, blood concentration, blood pressure, ECGj, neurologic status, and vision |
| Torasemide (2/32) | MED (2), TXT (1) | Loop diuretic | Body weight (1), electrolytes (1), renal function (1) | Electrolytes, creatinine, uric acid, blood glucose, lipids, leukocytes, erythrocytes, and platelets |
aThe first number in parenthesis shows the number of active pharmaceutical substances with a drug monitoring advice; the second number in parenthesis indicates the total amount of discharge letters, which had the active pharmaceutical substance included.
bThe number in parenthesis indicates how often the drug monitoring advice was located in the text or in the discharge medication.
cThe number in parenthesis indicates how often the drug monitoring parameter was recommended for the corresponding active pharmaceutical substance.
dTXT: text.
eMED: discharge medication.
fHMG-CoA: hydroxymethylglutaryl-coenzyme A.
gCK: creatine kinase.
hLDL: low-density lipoprotein.
iINR: international normalized ratio.
jECG: electrocardiogram.