Physicians’ Knowledge and Attitude Toward Therapeutic Drug Monitoring Practice in Southeastern Bangladesh: A Situation Analysis

Physicians’ Knowledge and Attitude Toward Therapeutic Drug Monitoring Practice in Southeastern Bangladesh: A Situation Analysis | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 19 January 2026 V1 Latest version Share on Physicians’ Knowledge and Attitude Toward Therapeutic Drug Monitoring Practice in Southeastern Bangladesh: A Situation Analysis Authors : Ruhina Sultana Anney , Roksana Reza , Mayin Uddin Mahmud 0000-0002-9152-7523 [email protected] , Maliha Ata , Rehnuma Urmi , Rozina Hoque Rani , Sayedul Mustaqim , Sefa Sarwath Alam , and Jannatul Ferdoush 0000-0002-6920-7267 Authors Info & Affiliations https://doi.org/10.22541/au.176882775.52012921/v1 126 views 43 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Aim: Therapeutic Drug Monitoring (TDM) optimizes drug efficacy and safety, yet its implementation in resource-limited settings like Bangladesh remains poorly characterized. This study aims to assess physicians’ knowledge, attitudes and perceived barriers regarding TDM, alongside current laboratory TDM practices and strategies to enhance its implementation in Chattogram, Bangladesh. Methods: A mixed-methods study was conducted involving 384 physicians from one public and one private tertiary hospital (quantitative survey), supplemented by data from four clinical laboratories and key informant interviews (KIIs) with five physicians (quantitative survey). The survey evaluated participant characteristics, TDM knowledge, attitudes and perceived barriers. KIIs explored professional experiences, laboratory standards, barriers, and improvement strategies for TDM implementation. Results: Nearly half (49.7%) of physicians demonstrated poor TDM knowledge, while 37.8% had moderate knowledge; only 12.5% possessed good knowledge. Despite favorable attitudes (76.0%), clinical adoption was very low (13.3%). Key systemic barriers included: unavailability of TDM tests (93.8%), absence of TDM training (93.5%), insufficient clinical guidelines (90.6%), and poor knowledge (89.3%). Laboratory data identified benzodiazepines as the most assayed drug class (60-180 tests annually/lab). Qualitative findings reinforced these barriers, highlighting inaccessible infrastructure, unreliable laboratories and sociocultural gaps. KIIs emphasized that multisectoral strategies include policy reform, education, quality assurance and priority-based access. Conclusion: Significant knowledge gaps and critically low utilization exist despite physicians’ positive attitudes toward TDM in Chattogram. Implementation is severely hindered by systemic barriers, notably unavailability, inadequate training, and lack of guidelines. Urgent, multifaceted interventions addressing these barriers are essential to improve TDM adoption and patient care in Bangladesh. Supplementary Material File (first submission in bjcp.docx) Download 117.85 KB Information & Authors Information Version history V1 Version 1 19 January 2026 Copyright This work is licensed under a Non Exclusive No Reuse License. Authors Affiliations Ruhina Sultana Anney Chattogram Medical College View all articles by this author Roksana Reza Chittagong Medical College View all articles by this author Mayin Uddin Mahmud 0000-0002-9152-7523 [email protected] Chittagong Medical College View all articles by this author Maliha Ata Chattogram Medical College View all articles by this author Rehnuma Urmi Chittagong Medical College View all articles by this author Rozina Hoque Rani Chattogram Medical College View all articles by this author Sayedul Mustaqim Chittagong Medical College View all articles by this author Sefa Sarwath Alam Chittagong Medical College View all articles by this author Jannatul Ferdoush 0000-0002-6920-7267 Bangabandhu Sheikh Mujib Medical University View all articles by this author Metrics & Citations Metrics Article Usage 126 views 43 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Ruhina Sultana Anney, Roksana Reza, Mayin Uddin Mahmud, et al. Physicians’ Knowledge and Attitude Toward Therapeutic Drug Monitoring Practice in Southeastern Bangladesh: A Situation Analysis. Authorea . 19 January 2026. DOI: https://doi.org/10.22541/au.176882775.52012921/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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