Evaluation of Equations for Prediction of Serum Digoxin Concentration at Digoxin Clinic in Community Hospitals

Abstract

Objective: To evaluate the calculation equation that was most suitable forpredicting serum digoxin in Thai patients. The equations included those ofSheiner, Sheiner 1977, Jusko, Yukawa (1997 and 2001), Bauer, Nagaraja,Bauman and Nakajud. Materials and Method: Blood samplings werecollected from 37 patients who received digoxin at least 7 consecutive daysat 3 community hospitals from January and September 2013. Results: Theresults revealed that most of the patients were female (67.6%), with anaverage age of 64.32 ± 10.4 years, average weight of 52.03 ± 10.9 kg,renal function in stage 3 (Clcr 30 – 59 ml/min) (62.2%), having atrialfibrillation (56.8%) and receiving digoxin dose of 125 mcg/day (67.6%).Most of serum concentrations were in therapeutic level (0.5 – 2.0 ng/ml)(78.4%). It was shown that Yukawa 2001 equation had no bias [meanprediction error = 0.08 (95%CI = -0.05 - 0.21)] and more accuracy [meanabsolute error = 0.21 (95%CI = 0.11 - 0.31)] than the other equations.Conclusion: The Yukawa 2001 equation was the most suitable method tobe used along with the provision of pharmaceutical care for patients usingdigoxin at digoxin clinic in community hospitals.Keywords: digoxin, prediction, serum digoxin, equation