Standards of Practice Committee

Standards of Laboratory Practice (SLP) Committee

The SLP Committee was founded in 1997 at the IATDMCT Congress in Vancouver with the objective of developing guidelines for standards of best practice in TDM-CT. During the early years two comprehensive surveys were conducted by Dr Ester Zylber-Katz who was the founding chair of this committee. Subsequently, during his chairmanship of this committee, Professor Pierre Marquet analyzed the results of the surveys and published its findings in a report which was published in the committee pages of the IATDMCT website.

Starting from 2005, at every biannual congress workshops were conducted under the auspices of this committee. These workshops have been fully subscribed and proved to be very successful.

The main purpose of this committee is to:

• act as a forum for exchange of knowledge on issues related TDM and Clinical Toxicology laboratory practice;
• help in the setting of guidelines for laboratory practice, including the interpretation of clinical data emanating from a TDM-Clinical Toxicology laboratory.

Membership List

Minutes of Committee Meeting at the Montreal Congress

In attendance were: Edgar Spencer (EPS, Chair), Ross Norris (RN), Ray Morris (RM), Don LeGatt, Vanessa Steenkamp, Phillip Morgan, Christine Collier (CC), Manuela Neuman, Matthew McMullin, Kathleen Barnett, Matthew Gist, John Wilson, Susannah Davies, Jodi Courtney, Philippe Vincent, Michelle Moreton, Jennifer Button (JB) and Mary-Ann Sanfacon.

Apologies for absence were received from: Christoph Hiemke (CH), Pierre Marquet, Daan Touw (DT), Milan Grundmann and Zuhier Awan who had other meetings to attend, and from the following former members who were unable to attend the Montreal congress: Phil Walson, Tai Kwong, Joseph Gal, John Williams and John Ray. Christoph Hiemke, who despite his onerous tasks as President and Chief Organiser of the AGNP biannual conference in Munich, Germany, which was happening at the same time as the congress in Montreal, had attended the SLP sponsored workshop as promised. Unfortunately he had to fly back to Germany immediately after the workshop.

Notes of the last meeting in Nice, France:  These were circulated to past members and copies are still available on the SLP committee pages of the IATDMCT website. Copies were not made available at this meeting.

Matters arising from the Nice meeting: The main objectives of the Nice meeting for the two years leading up to the Montreal congress was:

1. To organise another workshop under the auspices of this committee;
2. To complete the TDM guideline document and submit for publication prior to the Montreal congress, and also to produce a summary document of these guidelines in the form of a flyer;
3. To recruit more members to the committee;
4. To seek volunteers to take over the chair of this committee in Montreal.

Reports:

EPS reported that three of the four objectives had been met, despite the fact that the committee was completely dormant during the two years since the Nice meeting. Following discussions between EPS, CH & JB it was decided that it was a futile attempt to create the TDM guideline document as proposed in Nice, especially because the following websites provided very useful consensus documents for many groups of drugs:

Antiepileptic drugs – Best practice guidelines for TDM: A position paper by the sub-commission on TDM, ILAE Commission on Therapeutic Strategies. Epilepsia, 49(7): 1239-1276, 2008

Psychotropic drugs: Baumann, et al. The AGNP-TDM Expert Group Consensus Guidelines. Pharmacopsychiatry, 37: 243-265, 2004.

Antiretroviral drugs:

http://www.bhiva.org/cms1187440.asp

http://www.hivpharmacology.com

http://www.hiv-druginteractions.org

CH, the joint chair of this committee for the past four years has been extremely busy during the past two years since taking over the Presidency of AGNP (an European Neuropsychopharmacology and Pharmacopsychiatry Society). He is also the co-chair of the organising committee for IATDMCT 2011. Due to the severe extra demands on his time he has decided to step down as joint chair, but has agreed to remain an ordinary member. The committee wishes to place on record its appreciation and gratitude to CH for all his efforts during the past four years. He has contributed very significantly to promote the work of this committee during the past four years, and we look forward to his continued support in the years to come.

Though the committee has been dormant for the past two years, I was pleased to hear from those members who did write to tender their apologies for absence in Montreal. I am also very pleased to report that the membership has now risen from 13 to a staggering 28. The SLP committee sponsored workshop proved to be a good forum for recruiting all new members.

The workshop (W112) entitled “What would a benchmark TDM service look like? – Models of service delivery”, was a great success. Our speakers who were all highly experienced practitioners of TDM from Australia, Canada, South Africa and the UK brought an immense breadth of experience which hugely added to the very vibrant discussion at the end of the session. The committee owes a great debt of gratitude to RN and RM in helping to organise this workshop. On behalf of the committee EPS expressed his thanks and appreciation to both RN and RM.

In the absence of any other interested persons to assume the chair,  EPS had agreed to continue as Chair person for another term of two years. RN had also volunteered and elected unanimously as Chair-Elect for the two years leading up to the Stuttgart congress in 2011. It was decided that at the Stuttgart congress EPS would step down and RN would take the chair, and a new chair-elect would then be elected/appointed. This would ensure some succession planning for the chair of this committee.

Because of the lack of interest/activity during the post-congress years, EPS had preliminary discussions with DT, the chair of the Clinical Pharmacokinetics Committee about merging the two committees. This idea was also acceptable to the IATDMCT Executive, especially if it helped revive the new joint-committee. The Montreal congress saw an unprecedented rise in the SLP committee membership; however, EPS did make the suggestion to this committee about the proposed merger. The general consensus was that we remain the SLP Committee because the Clinical Pharmacokinetics Committee had a much narrower remit. EPS later conveyed the message to DT.

Main objectives for 2009 – 2011:

RM suggested the formation of an e-forum, such as Google/Yahoo group,  as a means for discussion and communication for the members of this group. There followed a discussion and various suggestions, including that by CC about the formation of such a group within the IATDMCT website. CC has had previous experience of setting up such groups for the Canadian Association of Clinical Chemistry and had agreed to set up such an email list group within the IATDMCT website.  To facilitate this, EPS was to forward to CC the email list of all members of this committee on his return from vacation. This e-forum would then be used for discussions and dissemination of information to all the membership. Any member, who so wishes, could have their name removed from the list.

EPS to circulate draft copy of minutes of the SLP Committee meeting in Montreal to all members for comment before posting a copy on the SLP committee pages of the IATDMCT website.

EPS to draft a brief report about the SLP committee activities, including the workshop, W112, and again circulate (hopefully via the e-forum) to members for comments/corrections. Comments would have to be received within prescribed time limits which will be notified with the draft. This would enable EPS to submit the finished article to the Compass editor in early 2010.

RN to help collate data emanating from the Montreal workshop (W112) with a view to preparing a manuscript for publication in the journal Therapeutic Drug Monitoring. Target date for completion of this task and submission of manuscript is prior to 2011. Ideally, the article should be published prior to the next congress. EPS and RN to set deadline dates for receipt of comments/input from the membership.

Any other business:

Subsequent to the Montreal congress RN has been busy in setting up a one-day symposium in Brisbane, Australia for the benefit of the various professional groups involved in the practice of TDM. This is supported by the following Australian professional societies: AACB, ASCEPT & SHPA. RN and EPS thought it appropriate for this committee to endorse this meeting on 12th March 2010. Approval was sought and granted from the IATDMCT Executive Committee.

 There being no further business, the meeting closed on time at 13:30h.

Edgar P Spencer
Chair, SLP Committee
November 2009

Committee Initiatives for 2010-2011: Under the auspices of this committee, Ross Norris, the Vice-Chair and other members in Australia have been instrumental in organising a one-day ‘Scientific Education Seminar’ in Brisbane, Australia on 12th March 2010. This seminar has been supported by the Australian Association of Clinical Biochemists, The Australasian Society of Clinical and Experimental Pharmacologists & Toxicologists and The Society of Hospital Pharmacists of Australia. Further details including registration forms are available on the IATDMCT website.

A list mail service of all members of the SLP Committee has been established jointly by Christine Collier and Elizabeth Hooper. This affords a confidential electronic forum for the membership to aid communication and discussion of matters pertinent to the committee.

During the course of the year a summary report of the proceedings from the workshop that was held in Montreal under the auspices of this committee, will be submitted to Dr Maria Shipkova for publication in the newsletter ‘The IATDMCT Compass’. This committee’s report is scheduled to be submitted for publication in Issue 4 of Compass with a deadline for submission of 15th November, 2010.

The committee also proposes to prepare a manuscript, based on the workshop in Montreal, for submission to the journal ‘Therapeutic Drug Monitoring’ prior to the IATDMCT Stuttgart Congress.        

This concludes the report to the IATDMCT Executive Committee.
Edgar P Spencer
Chair, Standards of Laboratory Practice (SLP) Committee
17th February, 2010