Best Practices to Implement Dried Blood Spot Sampling for Therapeutic Drug Monitoring in Clinical Practice

Abstract

Background: Sampling of blood at home to determine the concentration of drugs or other compounds can be effective in limiting hospital-based sampling. This could lower hospital visits and patient burden, improve the quality of life, and reduce health care costs. Dried blood spot (DBS) microsampling is often used for this purpose, wherein capillary blood, obtained by pricking the heel or finger, is used to measure different analytes. Although DBS has several advantages over venous blood sampling, it is not routinely implemented in clinical practice. To facilitate the bench to bedside transition, it is important to be aware of certain challenges that need to be considered and addressed. Results: Here, important considerations regarding the implementation of DBS in clinical practice, the choice of patients, blood sampling, transport, and laboratory analysis are discussed. In addition, we share our experience and provide suggestions on how to deal with these problems in a clinical setting.

Clinical performance of volumetric finger‐prick sampling for the monitoring of tacrolimus, creatinine and haemoglobin in kidney transplant recipients

“…Implementation of this type of activity in clinical practice requires a carefully thought-out process to ensure feasibility. 14 In conclusion, dried blood samples in the form of Capitainer ®…”

“…Introduction of self‐sampling at home for tacrolimus, creatinine and haemoglobin creates a possibility to monitor some key elements in the transplant recipient without the fear of being infected. Implementation of this type of activity in clinical practice requires a carefully thought‐out process to ensure feasibility 14 …”

Therapeutic monitoring of plasma clozapine andN-desmethylclozapine (norclozapine): practical considerations

“…Dried blood spots (DBS), usually collected from a ‘finger-prick’ sample onto a purpose-designed card or other sampling device, present an alternative to conventional sampling for clozapine TDM (Geers 2017). However, there are many problems in relating the results obtained to those obtained from plasma, in addition to the obvious fact that finger-prick capillary blood is not venous plasma (Francke 2022). Collection directly onto DBS cards means that taking an accurate volume of liquid blood for analysis is not always possible.…”

Volumetric Absorptive Microsampling to Enhance the Therapeutic Drug Monitoring of Tacrolimus and Mycophenolic Acid: A Systematic Review and Critical Assessment

“…92 Regardless, adequate patient training is important to ensure success. Francke et al 93 provided a comprehensive discussion on potential education strategies based on their experience with traditional DBS, which is also likely relevant to VAMS. Alternatively, selecting the Tasso-M20 device may facilitate adequate collection, as the device simplifies the process to a greater extent.…”