Leicester School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK.
Clin Chem Lab Med. 2020 Apr 28;58(5):643-663. doi: 10.1515/cclm-2019-0820.
Nonadherence to prescribed pharmacotherapy is an understated public health problem globally and is costing many patients their chance to return to good health and healthcare systems billions. Clinicians need an accurate assessment of adherence to medications to aid the clinical decision-making process in the event of poor patient progress and to maximise the patient health outcomes from the drug therapies prescribed. An overview of indirect and direct methods used to measure medication adherence is presented, highlighting the potential for accurate measuring of drugs in biological samples using hyphenated mass spectrometry (MS) techniques to provide healthcare professionals with a reliable evidence base for clinical decision making. In this review we summarise published applications of hyphenated MS techniques for a diverse range of clinical areas demonstrating the rise in the use of such direct methods for assessing medication adherence. Although liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods using plasma, serum and urine samples are the most popular, in recent years increased attention has been given to liquid chromatography high-resolution mass spectrometry (LC-HRMS) methods and alternative biosample matrices including hair, saliva and blood microsamples. The advantages and challenges of using hyphenated MS techniques to address this healthcare problem are also discussed alongside future perspectives.
不遵医嘱用药是一个被低估的全球性公共卫生问题，它使许多患者失去了恢复健康的机会，也使医疗系统损失了数十亿美元。临床医生需要对药物治疗的依从性进行准确评估，以帮助在患者病情不佳时做出临床决策，并最大限度地提高患者对所开药物治疗的健康效果。本文介绍了间接和直接测量药物依从性的方法，强调了使用联用质谱 (MS) 技术在生物样本中准确测量药物的潜力，为临床决策提供可靠的证据基础。本文总结了联用 MS 技术在多个临床领域的应用，证明了直接方法在评估药物依从性方面的应用越来越多。尽管基于液相色谱-串联质谱 (LC-MS/MS) 方法的血浆、血清和尿液样本最受欢迎，但近年来，人们越来越关注液相色谱-高分辨质谱 (LC-HRMS) 方法和替代生物样本基质，包括头发、唾液和血液微样本。本文还讨论了使用联用 MS 技术解决这一医疗保健问题的优缺点及未来展望。
