Knowledge and Awareness of Therapeutic Drug Monitoring Among Clinicians in a Teaching Hospital in Benue State

Therapeutic drug monitoring is a critical tool for optimising drug therapy in patients receiving narrow therapeutic index medications, yet its clinical application in Nigerian hospitals is often limited by inadequate clinician awareness. This study assessed the knowledge, attitudes, and practices of clinicians regarding therapeutic drug monitoring at Benue State University Teaching Hospital in Makurdi, North Central Nigeria. A cross-sectional descriptive survey was conducted among 110 clinicians including medical officers, resident doctors, and consultants. A structured questionnaire assessed TDM knowledge, clinical indications for monitoring, sample collection procedures, interpretation of results, and perceived barriers to implementation. Results showed adequate overall TDM knowledge in 48.2 percent of respondents. Knowledge was highest for aminoglycosides (61.8 percent) and lowest for antiepileptics (37.3 percent). Routine use of TDM in clinical practice was reported by only 30.0 percent of respondents. The most common barriers to TDM implementation were lack of laboratory capacity for drug assays (72.7 percent), absence of TDM protocols (58.2 percent), and insufficient pharmacist involvement in TDM interpretation (47.3 percent). Senior clinical staff demonstrated significantly higher TDM knowledge scores (p < 0.01). The study concludes that TDM knowledge and use are insufficient in this hospital and recommends developing institutional TDM protocols, building laboratory assay capacity, and providing clinician-pharmacist collaborative TDM education workshops. Keywords: therapeutic drug monitoring, clinician knowledge, narrow therapeutic index, Benue State, clinical pharmacy