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

Dried blood spot (DBS) sampling offers several advantages for therapeutic drug monitoring, including minimal invasiveness, low blood volume requirements, and potential for home sampling. However, obtaining spots of sufficient quality for reliable analysis remains a key challenge of DBS. This study aimed to evaluate the impact of enhanced visual and textual guidance on the quality of DBS by analyzing data from a prospective multicenter study involving children and adolescents.

In total, 108 DBS cards from 56 children were assessed for spot quality. Rejection criteria included spot diameter <6 mm, smeared or irregularly shaped spots, and overlapping spots. Approval and rejection rates, overall success rates of DBS cards, and the most common rejection reasons were compared between the groups that did and did not receive the enhanced visual and textual support (intervention).

Pre-intervention : 47.6% of the DBS cards contained at least 1 spot qualitatively acceptable for analysis, and 25.7% of all spots qualified for analysis. Post-intervention : the acceptance rates increased to 86.6% and 64.3%, respectively. In both the pre- and post-intervention groups , the most common reason for rejection was the presence of smeared or irregularly shaped spots.

Continued improvements in DBS quality rely on effectively addressing challenges associated with home sampling challenges, which is critical for the seamless incorporation of DBS into clinical practice.