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Feasibility of Capillary Self-Collected Blood Specimens for Routine Outpatient Laboratory Testing
Chelsea B Swartchick1, Rachana Gurudu1, Nathanael S Lexvold1
1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States.
Insights
Capillary self-collection (CSC) devices offer a convenient at-home blood collection method. However, potassium, bicarbonate, and glucose stability in CSC serum requires careful consideration during transport and testing.
Area of Science:
- Clinical Chemistry
- Point-of-Care Testing
- Patient-Reported Outcomes
Background:
- Capillary self-collection (CSC) devices enable at-home blood sample collection, potentially reducing clinic visits.
- Evaluating patient experience and analytical performance of CSC devices is crucial for adoption.
Purpose of the Study:
- Assess patient experience with commercial CSC devices.
- Identify common laboratory test groupings to minimize appointments.
- Evaluate the analytical performance of CSC samples for key laboratory tests.
Main Methods:
- User experience evaluated for three CSC devices.
- Clinical feasibility assessed by comparing CSC and venipuncture (VP) serum samples.
- Analyzed stability of CSC samples under simulated shipping conditions (delayed processing, temperature extremes).
Main Results:
- Patients found CSC devices easy to use and painless.
- Immediate processing showed minimal clinical differences (potassium, bicarbonate).
- Delayed processing (48h room temp) revealed differences in potassium, bicarbonate, and glucose.
- High temperature (40°C) for 48h impacted most analytes except creatinine, lipids, PSA, and thyroid cascade.
Conclusions:
- Potassium, bicarbonate, and glucose demonstrate limited stability in CSC serum at room temperature.
- CSC serum is a viable option, but requires analyte-specific stability assessment and controlled transportation.
Background:
Capillary self-collection (CSC) devices allow patients to collect blood samples at home, potentially reducing outpatient phlebotomy visits. This study aimed to (a) assess the patient experience with multiple commercially available CSC devices; (b) determine which laboratory tests are commonly ordered together, which could reduce the need for appointments; and (c) evaluate the analytical performance of these tests using CSC samples.
Methods:
User experience for 3 CSC devices was evaluated. Clinical feasibility was determined by comparing test results in paired sera collected by venipuncture (VP) and CSC devices. VP samples were centrifuged within 2 h and tested immediately. CSC sera were centrifuged and tested both immediately and after delayed processing to simulate shipping temperature extremes (-20°C or 40°C). Basic metabolic panel, lipid panel, thyroid function cascade, and prostate-specific antigen were evaluated. Differences between VP and CSC collections were characterized according to their statistical and clinical differences.
Results:
Patients reported CSC devices were easy to use and painless. Clinically significant differences between VP and CSC sera processed immediately were limited to potassium and bicarbonate. Following delayed processing of CSC serum samples (48 h at room temperature), clinically significant differences in potassium, bicarbonate, and glucose were observed. Frozen samples could not be analyzed. A 48 h delay at 40°C caused clinically significant differences in all analytes except creatinine, lipid panel, prostate-specific antigen, and the thyroid cascade.
Conclusion:
Potassium, bicarbonate, and glucose were not stable at room temperature in CSC sera. CSC serum specimens may be a viable option but require analyte-specific evaluation and consideration of transportation conditions.
