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Romolo M. Dorizzi, MD; Giuliano Dall'Olio, PhD; Marco Caputo, MD
Laboratorio Chimica Clinica ed Ematologia Azienda Ospedaliera di Verona Verona, Italy Laboratorio Chimica Clinica ed Ematologia Ospedale Vicenza Vicenza, Italy

JAMA. 1996;275(10):757-758.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Although the article by Dr Schoenenberger and colleagues¹ discusses the frequent inappropriateness of antiepileptic drug level monitoring, we suggest that habit and routine, more than diagnostic reasoning, often drive the physician's test requests of therapeutic drug monitoring. The fee-for-service policy of the National Health System in Italy greatly encourages drug monitoring for drugs such as quinidine for which the value of monitoring has not been established.^2,3 Since the dosage of quinidine commonly used in Italy is low (400 to 600 mg per day), an eerie situation developed in all the clinical laboratories in which therepeutic monitoring of quinidine is carried out: its concentration rarely reaches the therapeutic interval (ie, 6 to 15 µmol/L [2 to 5 µg/mL]).³

To measure this phenomenon, we collected the results of all quinidine assays obtained for inpatients and outpatients during different spans of time since 1990 in four hospital . . . [Full Text PDF of this Article]

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