In at-home and trial settings, a wet capillary device reliably collected a median ~450 µL with a 4.4% failure rate; 88% of adults preferred self-collection over venipuncture, with lower pain.
This systematic review of 67 studies involving 34,739 kidney disease patients found dried blood microsampling was mainly used for immunosuppressant therapeutic drug monitoring and kidney function assessment. The approach offered cost savings, was preferred by patients for home self-collection, and provides a patient-centric opportunity to upscale longitudinal sampling and reduce participation bias in decentralised kidney disease research.
This review found that volumetric microsampling devices, such as Mitra, HemaPEN, HemaXis DB10, and Tasso-M20, overcome haematocrit bias, whilst Telimmune plasma separation cards enable direct plasma collection without centrifugation. These technologies support patient-centric, decentralised sampling, though the authors note that clinical validation remains limited across different drugs and patient populations.
A machine learning model called Remote Control was trained on 2685 blood samples to predict change due to instability, enabling accurate calibration of results to approximate the time zero value at collection. With calibration, unprocessed whole blood could be transported for up to 9 days under ambient conditions and temperatures between 3.4 and 47.4 degrees Celsius, achieving agreement with CLIA TEa between 98.1 and 100 per cent and expanding the catalog of tests available for at-home collection.
Volumetric microsampling can enable patient-centred therapeutic drug monitoring with high patient preference and acceptable method validation for many drugs, but conversion from capillary to plasma and agreement with venous sampling varies by analyte and requires careful validation.