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This is due to its variable pharmacokinetics (both between and within individual patients), narrow therapeutic index, and the severe consequences of over\u2010 and underexposure, which may cause toxicity and rejection, respectively. Tacrolimus is, therefore, routinely dosed by means of therapeutic drug monitoring (TDM). TDM is performed for as long as the transplant functions and frequent and often lifelong sampling is therefore the rule. This puts a significant burden on patients and transplant professionals and is associated with high healthcare\u2010associated costs. Furthermore, by its very nature, TDM is reactive and has no predictive power. Finally, the current practice of TDM does not foresee in an active role for patients themselves. Rather, the physician or pharmacist prescribes the next tacrolimus dose after obtaining the concentration measurement test results. In this article, we propose a strategy of patient\u2010controlled, home\u2010based, self\u2010TDM of the immunosuppressant tacrolimus after transplantation. We argue that with the combined use of population tacrolimus pharmacokinetic models, home\u2010based sampling by means of dried blood spotting and implementation of telemedicine, this may become a feasible approach in the near future.<\/jats:p>","DOI":"10.1111\/bcp.16121","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T20:33:18Z","timestamp":1717446798000},"page":"1560-1568","source":"Crossref","is-referenced-by-count":8,"title":["Removing the physician from the equation: Patient\u2010controlled, home\u2010based therapeutic drug self\u2010monitoring of tacrolimus"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1823-7003","authenticated-orcid":false,"given":"Marinus","family":"Hazenbroek","sequence":"first","affiliation":[{"name":"Erasmus MC Transplant Institute University Medical Center Rotterdam  Rotterdam the Netherlands"},{"name":"Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC University Medical Center Rotterdam  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9620-8639","authenticated-orcid":false,"given":"Liset H. 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