Optimizing Dried Blood Spot Sampling for Children and Adolescents With Autism Spectrum Disorder

Area of Science:

• Pharmacokinetics and Drug Metabolism
• Clinical Chemistry
• Pediatric Medicine

Background:

• Dried blood spot (DBS) sampling offers advantages for therapeutic drug monitoring (TDM) like minimal invasiveness and home sampling potential.
• However, ensuring adequate DBS quality for reliable analysis remains a significant challenge.
• This study investigated methods to improve DBS quality in pediatric TDM.

Purpose of the Study:

• To evaluate the impact of enhanced visual and textual guidance on dried blood spot (DBS) quality.
• To assess the effect of improved guidance on acceptance and rejection rates for DBS cards in pediatric patients.
• To identify common reasons for DBS rejection and how they are affected by the intervention.

Main Methods:

• A prospective multicenter study involved assessing 108 DBS cards from 56 children and adolescents.
• DBS cards were evaluated based on spot diameter, shape, and overlap, with defined rejection criteria.
• Comparison of DBS quality metrics (approval, rejection, success rates) between groups with and without enhanced guidance.

Main Results:

• Pre-intervention, only 47.6% of DBS cards had acceptable spots, and 25.7% of all spots qualified for analysis.
• Post-intervention, acceptance rates dramatically increased to 86.6% for cards and 64.3% for spots.
• Smeared or irregularly shaped spots remained the primary reason for rejection in both groups.

Conclusions:

• Enhanced guidance significantly improves DBS quality, crucial for reliable pediatric TDM.
• Addressing home sampling challenges is vital for seamless integration of DBS into clinical practice.
• Further optimization of guidance is needed to minimize common rejection reasons like irregular spot morphology.