Figure 1. Patient Selection.

Table 1. Patient Demographics.

Table 1. Patient Demographics.

VariableN = 40 MedianSDAge (years)44.0 (19–90)17.83Weight (kilograms)82.0 (52.0–167.2)26.9Height (centimetres)175 (167–180)5.2Creatinine (µmole/L)
(Reference Range 45–90 µmol/L)79 (41–657)124.4SexMale25 (63%)Female15 (37%)

Table 2. Pharmacist Demographics.

Table 2. Pharmacist Demographics.

VariableN = 15SexFemale12 (80%)Male3 (20%)Years Registered (mean)9.1 years (1–20)Postgraduate QualificationNo qualification7 (46.7%)Graduate Certificate2 (13.3%)Graduate Diploma4 (26.7%)Master’s degree2 (13.3%)

Table 3. TDM sample timing (Medical officers and Pharmacist) (n = 40 patients, 103 observations).

Table 3. TDM sample timing (Medical officers and Pharmacist) (n = 40 patients, 103 observations).

Outcome: Appropriately Timed TDM Sample VariableObservations (N)Percentage (%)Medical Officer (Control Group)18/5234.6%Pharmacist50/5198.0%VariableAdjusted Odds Ratio #95% CIPharmacist Involvement #Yes87.1 *(11.5, 661.1)NoRefRef

Table 4. Vancomycin dose adjustments (Medical officers vs Pharmacist (n = 40 patients, 103 observations).

Table 4. Vancomycin dose adjustments (Medical officers vs Pharmacist (n = 40 patients, 103 observations).

Outcome: Appropriate Maintenance Dose Calculation and Adjustment (Maintenance Dose) VariableObservations (N)Percentage (%)Medical Officer (Control Group)22/2975.8%Pharmacist 49/5196.1%VariableAdjusted Odds Ratio #95% CIPharmacist Involvement #Yes19.1 *(1.7, 213.5)NoRefRef

Table 5. Results of appropriate documentation of TDM information in patient medical records.

Table 5. Results of appropriate documentation of TDM information in patient medical records.

Outcome: Appropriate Documentation for TDM VariableObservations (N)Percentage (%)Medical Officer (Control Group)27/5251.9%Pharmacist 51/51100.0%

Table 6. Pre- and post-credentialling package confidence questionnaire.

Table 6. Pre- and post-credentialling package confidence questionnaire.

Post-Credentialling Confidence Rating Greater than Pre-Credentialling Ratingp-Value a1. I feel confident providing advice on vancomycin therapeutic drug monitoring0.012. I feel confident about when to recommend an initial drug measurement level for vancomycin therapeutic drug<0.0013. I do not feel confident about when to recommend subsequent drug measurement levels for vancomycin0.104. I am unsure which infections vancomycin is used to treat<0.0015. I feel unsure about providing advice on vancomycin dosing and monitoring in obese patients0.106. I feel confident in providing advice on vancomycin dosing and monitoring in renal patients0.017. I feel confident in recommending vancomycin loading doses0.018. I feel confident in recommending vancomycin maintenance doses0.019. I am familiar with the guidelines and policies around vancomycin and vancomycin0.0110. I actively provide advice to the multidisciplinary team about Vancomycin Therapeutic Drug Monitoring0.0211. I feel the multidisciplinary team are receptive of my advice provided for vancomycin therapeutic drug monitoring0.04