{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:53:36Z","timestamp":1793087616029,"version":"4.5.0"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJHP"],"abstract":"<jats:p>ABSTRACTBackground: Currently, there is no standardized approach to the frequency of monitoring tacrolimus levels in patients who have undergone hematopoietic stem cell transplant (HSCT). Previously, the practice at the study hospital was to monitor tacrolimus levels daily throughout a patient\u2019s admission. A recent institutional study suggested that measurement of tacrolimus level is more frequent than needed to achieve consistent time in the therapeutic range (TTR), particularly after the first 7 days. As a result, tacrolimus monitoring was changed to daily measurement for the initial week of therapy, followed by measurements on Monday, Wednesday, and Friday in subsequent weeks.Objective:To confirm the safety and efficacy of the recent practice change.Methods: This retrospective chart review of HSCT patients admitted to The Ottawa Hospital involved 68 patients in the pre\u2013practice change group and 43 patients in the post\u2013practice change group. Data on tacrolimus measurement were collected for up to 21 days after initiation of this medication. The proportion of TTR was compared between the2 groups. Differences in the incidence and severity of renal dysfunction and the incidence of acute graft versus host disease (GVHD) were determined and described.Results: In the pre\u2013practice change cohort, the median proportion of TTR for tacrolimus was 40.5% for days 1\u20137, 65.1% for days 8\u201314, and 78.9% for days 15\u201321, similar to the values for the post\u2013practice change group (46.6% [p = 0.09], 62.9% [p = 0.93], and 70.0% [p = 0.22], respectively, for the same periods). The incidence of acute GVHD within 100 days after HSCT was 24% and 33% for the pre\u2013 and post\u2013practice change cohorts, respectively. The incidence and severity of renal dysfunction were similar between the 2 groups.Conclusion:The proportion of TTR for tacrolimus was not significantly affected by the recent practice change. Similarly, the incidence and severity of renal dysfunction and the incidence of acute GVHD did not appear to differ between the pre\u2013 and post\u2013practice change groups.R\u00c9SUM\u00c9Contexte : Il n\u2019existe actuellement aucune approche standardis\u00e9e portant sur la fr\u00e9quence des contr\u00f4les des valeurs du tacrolimus pour les patients ayant subi une greffe de cellules souches h\u00e9matopo\u00ef\u00e9tiques (GCSH). Dans le pass\u00e9, la pratique \u00e0 l\u2019h\u00f4pital o\u00f9 s\u2019est d\u00e9roul\u00e9e l\u2019\u00e9tude consistait \u00e0 les contr\u00f4ler quotidiennement durant tout le s\u00e9jour du patient. Une r\u00e9cente \u00e9tude institutionnelle a laiss\u00e9 entendre que cette mesure \u00e9tait plus fr\u00e9quente que n\u00e9cessaire pour obtenir une marge th\u00e9rapeutique r\u00e9guli\u00e8re (TTR), particuli\u00e8rement apr\u00e8s les sept premiers jours. Par cons\u00e9quent, une modification du contr\u00f4le des valeurs du tacrolimus pr\u00e9conise d\u00e9sormais des mesures quotidiennes pendant la premi\u00e8re semaine de la th\u00e9rapie, suivies de mesures le lundi, le mercredi et le vendredi au coursdes semaines suivantes.Objectif : Confirmer la s\u00e9curit\u00e9 et l\u2019efficacit\u00e9 du r\u00e9cent changement apport\u00e9 \u00e0 la pratique.M\u00e9thode : Cet examen r\u00e9trospectif des dossiers des patients GCSH admis \u00e0 l\u2019H\u00f4pital d\u2019Ottawa concernait 68 patients du groupe \u00ab avant le changement de pratique \u00bb et 43 du groupe \u00ab apr\u00e8s le changement de pratique \u00bb. Les donn\u00e9es relatives aux mesures des valeurs du tacrolimus ont \u00e9t\u00e9 recueillies pendant les 21 premiers jours apr\u00e8s le d\u00e9but de l\u2019administration de ce m\u00e9dicament. La comparaison entre les deux groupes portait sur la proportion de TTR. Les diff\u00e9rences d\u2019incidence et de gravit\u00e9 du dysfonctionnement r\u00e9nal et l\u2019apparition de r\u00e9action aigu\u00eb du griffon contre l\u2019h\u00f4te (GVHD) ont \u00e9t\u00e9 d\u00e9finies et d\u00e9crites.R\u00e9sultats : Dans la cohorte \u00ab avant le changement de pratique \u00bb, la proportion moyenne de TTR du tacrolimus \u00e9tait de 40,5 % du 1er au 7e jour; de 65,1 % du 8e au 14e jour et de 78,9 % du 15e au 21e jour. Ces valeurs sont similaires \u00e0 celles du groupe \u00ab apr\u00e8s le changement de pratique \u00bb (respectivement 46,6 % [p = 0,09], 62,9 % [p = 0,93] et 70,0 % [p = 0,22] pendant les m\u00eames p\u00e9riodes). L\u2019incidence de r\u00e9action aigu\u00eb du greffon contre l'h\u00f4te dans les 100 jours apr\u00e8s la GCSH se montait respectivement \u00e0 24 % et \u00e0 33 % dans les cohortes \u00ab avant et apr\u00e8s le changement de pratique \u00bb. L\u2019incidence et la gravit\u00e9 du dysfonctionnement r\u00e9nal \u00e9taient similaires dans les deux groupes.Conclusion : La proportion de TTR relative au tacrolimus n\u2019a pas \u00e9t\u00e9 modifi\u00e9e de mani\u00e8re significative par le changement r\u00e9cent de pratique. De m\u00eame, l\u2019incidence et la gravit\u00e9 du dysfonctionnement r\u00e9nal et l\u2019incidence de r\u00e9action aigu\u00eb du greffon contre l\u2019h\u00f4te ne semblaient pas diff\u00e9rer entre les groupes avant et apr\u00e8s le changement de pratique.<\/jats:p>","DOI":"10.4212\/cjhp.v73i1.2956","type":"journal-article","created":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T18:46:43Z","timestamp":1582224403000},"source":"Crossref","is-referenced-by-count":3,"title":["Efficacy, Safety, and Practicality of Tacrolimus Monitoring after Bone Marrow Transplant: Assessment of a Change in Practice"],"prefix":"10.4212","volume":"73","author":[{"given":"Jacky","family":"Cheung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Wentzell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Trinacty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Gigu\u00e8re","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Kekre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2732","published-online":{"date-parts":[[2020,2,20]]},"container-title":["The Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/2956\/4133","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/2956\/4134","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/2956\/4133","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T02:13:00Z","timestamp":1607479980000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/2956"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,20]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,2,20]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.v73i1.2956","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"value":"1920-2903","type":"electronic"},{"value":"0008-4123","type":"print"}],"subject":[],"published":{"date-parts":[[2020,2,20]]}}}