A Scoping Review Protocol to Identify Barriers and Facilitators to the Implementation of Therapeutic Drug Monitoring in African Countries

This scoping review aims to map and synthesize existing evidence on the barriers and facilitators to implementing therapeutic drug monitoring (TDM) services in African countries. TDM, defined as the measurement and clinical interpretation of drug concentrations to optimize efficacy and minimize toxicity, is well established in many high‑income settings but remains limited and unevenly distributed across African health systems, where infrastructure, funding, workforce capacity, and awareness gaps have been reported. Using the Joanna Briggs Institute methodology and PRISMA‑ScR guidance, and guided by a Population–Concept–Context (PCC) framework, the review will include studies involving patients, healthcare providers, laboratories, and health‑system actors, focusing on reported barriers, facilitators, and implementation experiences of TDM across any therapeutic area. A comprehensive search of major bibliographic databases and grey literature from January 2000 onwards will be conducted, with two independent reviewers screening, charting, and synthesizing data using descriptive and thematic analysis. Findings will identify key implementation challenges, enabling factors, and evidence gaps to inform future TDM implementation strategies, research priorities, and policy development in African settings.