Microsampling Devices for Routine Therapeutic Drug Monitoring—Are We There Yet?

Abstract

Background: The use of microsampling for therapeutic drug monitoring (TDM) is increasingly feasible as sensitive methods have become more accessible. There exists an increasing interest in the use of microsampling, and new microsampling devices and techniques can potentially improve patient convenience and care, among other features. This review provides an update on currently validated methods for measuring drugs pertinent to TDM, including data from clinical samples.Methods: A literature record search was undertaken, including PubMed and Google Scholar. Reports that included the use of microsampling to measure concentrations of drugs associated with TDM were reviewed and included if data from patient samples were reported. The studies are described in brief, including sample preparation and analyte stability, with the most pertinent findings reported.Results: Sensitive analyses and innovative designs and materials have resulted in an increasing number of reported evaluations and validations for measuring drugs using microsamples. Novel designs largely overcome common problems associated with traditional dried blood spot sampling. Although examples of patient self-sampling are rare at present, studies that evaluated feedback found it to be largely positive, revealing the feasibility of microsampling for TDM. Conclusions:Microsampling is suited to the TDM of numerous drugs in diverse situations, and it will play an increasingly important role. The issues with traditional dried blood spot samples have been largely overcome by employing novel methods to obtain volumetric samples.

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“…Even more, participants in this pilot study preferred this type of sampling over a conventional blood draw, but this needs to be confirmed in a larger cohort. This is in agreement with results obtained by Morgan et al, who showed that 81% of the participants preferred VAMS collection, and is in line with the preference for VAMS in the cohort studied by Verougstraete et al [23,32]. Essential to implementation, we also investigated the time it took for a sample to reach our laboratory.…”

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“…To decentralize the collection of blood, cutaneous capillary blood is a good alternative as it can easily be self-sampled by finger pricking using an external piercing element [ 2 ]. However, in addition to still being relatively invasive, obtaining acceptable quantities while maintaining adequate quality is often challenging [ 3 , 4 , 5 ]. Furthermore, the generated blood droplet has to be deposited manually on, for instance, the inlet of a point-of-care diagnostic test or a dried blood spot card, which often leads to volume losses or inaccurate results.…”

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“…Such methods have been applied to metabolic phenotyping experiments that have assessed outcomes of health and disease including inflammation [17], cardiometabolic diseases [21], dementia [17], and nutrition [22]; they are commonly targeted for many clinical and human physiology studies. This move towards sample miniaturisation in the space of metabolic phenotyping has led research teams to begin the evaluation of microsamples over traditional venepuncture for sample collection [23].…”