Department of Pharmacy, Jeroen Bosch Hospital.
Reinier van Arkel Mental Health Institute, 's-Hertogenbosch.
Int Clin Psychopharmacol. 2024 Jan 1;39(1):23-28. doi: 10.1097/YIC.0000000000000494. Epub 2023 Aug 7.
Patients may be reluctant to start clozapine (CLZ) because of the frequent blood sampling needed for white blood cell monitoring, but also therapeutic drug monitoring of CLZ. Finger prick, instead of venepuncture, might lower the threshold to CLZ use. The aim of this study was to determine whether CLZ concentrations are the same in capillary and venous blood samples. Capillary blood was drawn by finger prick and collected in the Hem-Col tube. Paired capillary and venous blood samples were collected from inpatients and outpatients of a mental health institute. Patients were asked to rate pain, experience, and preference for blood sampling method. Passing-Bablok analysis of 40 paired samples showed that CLZ concentrations were statistically equal in capillary and venous samples {slope 0.96 [95% confidence interval (CI): 0.88-1.04], intercept -6.86 (95% CI: -30.75 to 24.13)}. Venepuncture was the preferred method based on the experience ( P = 0.009) and preference ( P = 0.043) items. In conclusion, CLZ concentrations were similar in venous and capillary blood samples. Venepuncture appeared to be preferred to finger prick for blood sampling. Our results emphasize the importance of consulting patients' individual preference for blood sampling method.
患者可能因为需要频繁采集白细胞监测样本而不愿意开始使用氯氮平（CLZ），但也需要对 CLZ 进行治疗药物监测。使用指尖采血而非静脉穿刺可能会降低使用 CLZ 的门槛。本研究旨在确定毛细血管血和静脉血样本中的 CLZ 浓度是否相同。通过指尖刺破采血，将血液收集在 Hem-Col 管中。从一家心理健康机构的住院患者和门诊患者中采集配对的毛细血管血和静脉血样本。患者被要求对采血方法的疼痛、体验和偏好进行评分。40 对配对样本的 Passing-Bablok 分析表明，毛细血管和静脉样本中的 CLZ 浓度具有统计学上的等同性{斜率 0.96（95%置信区间：0.88-1.04），截距-6.86（95%置信区间：-30.75 至 24.13）}。根据体验（P=0.009）和偏好（P=0.043）项目，静脉穿刺是首选方法。总之，静脉和毛细血管血样本中的 CLZ 浓度相似。静脉穿刺似乎比指尖采血更受青睐。我们的结果强调了咨询患者对采血方法的个体偏好的重要性。
