Issues in the Preanalytical Process of Specimens for Laboratory Tests in Home Healthcare Settings

Home healthcare has recently been promoted in response to the increase in vulnerable people, such as elderly patients who can have difficulty accessing clinics and hospitals in Japan. A characteristic specific to home healthcare is that laboratory tests using specimens are conducted by transport from home to laboratory centers or by point-of-care testing at home. In this case, several issues can lead to inaccurate test values. This narrative literature review summarizes issues in the preanalytical process, a critical phase for ensuring the accuracy of laboratory tests. Specimen collection may not always be smooth in the pathological conditions of some elderly patients and/or in the non-clinic/hospital environments. The preservation of specimens, considering prolonged pre-centrifugation time and storage temperature, can alter the values of various analytes, including blood glucose, potassium, and lactate dehydrogenase. In addition, hemolytic phenomenon caused by insufficient specimen collection, vibration during specimen transport, and excessive milking during fingertip blood sampling can also be an issue. Awareness of the preanalytical process in testing specimens is important for obtaining accurate laboratory tests in home healthcare settings. This comprehensively summarized paper will be helpful in securing test quality and patient care.