Completion of therapeutic and safety monitoring tests in Lebanese outpatients on chronic medications: a cross-sectional study

PURPOSE To evaluate the appropriateness of laboratory-test monitoring recommended for patients on chronic medication therapies in the Lebanese community setting. PATIENTS AND METHODS In October 2011, all outpatients visiting selected community pharmacies in Lebanon were screened by pharmacists to evaluate their use of one or more chronic medications requiring safety and/or therapeutic laboratory tests. The list of medications was elaborated after an extensive review of laboratory-test monitoring recommendations from pertinent up-to-date clinical guidelines, medications that have been issued black box warnings for monitoring, and the most current information from the US Food and Drug Administration website. Patients receiving these medications were subjected to a questionnaire assessing the appropriateness of their laboratory-test monitoring. The study was approved by the Lebanese American University's Institutional Review Board. RESULTS A total of 284 outpatients, with almost equal distribution by sex, were identified during the aforementioned period to be on one or more of the specified medications. The majority of the sample (68%) was younger than 65 years of age. Overall, most of the study group (65%) were found to be partially monitored with laboratory tests, while only 27% were fully monitored and 8% were not monitored at all. The study group reported clinic-visit intervals as follows: more than a year (35%), on yearly basis (18%), every 6 months (25%), every 3 months (16%), less than 3 months (6%). CONCLUSION Seventy-three percent (73%) of the study group were receiving incomplete therapeutic/safety laboratory-test monitoring recommended for patients on chronic medication in the Lebanese community. It is concluded from the results that patients need to better understand the importance of recommended test monitoring for the safe and effective use of their medications. Education by physicians may be required to achieve better understanding.