Feasibility of Self-Collected Dried Blood Spot Samples during a 30 Day Period in Persons with Multiple Sclerosis

Background: Biomarkers may identify early disease activity or progression in patients with multiple sclerosis (MS). Patients typically travel to clinical settings for laboratory tests. This process is time-consuming, costly and difficult for patients with limited mobility. Self-administered blood collection using dried blood spot (DBS) kits may reduce the burden of diagnostic testing among patients with chronic diseases such as MS.   

Objectives: To describe perspectives and adherence to DBS collection overall and at different frequencies of blood collection among subjects with and without MS.

Methods: A total 23 subjects with MS and 10 without MS participated. Participants were assigned to collect DBS samples at home for 30 days using a HemaSpot (SpotOn Sciences) DBS kit every 3 days (Group A, n=17) or every 6 days (Group B, n=16). Descriptive data included age, gender, ethnicity, insurance, anxiety about the finger prick, and NeuroQol fatigue and mobility scores. Subjects completed a questionnaire about perceptions of the DBS collection process. Data analysis included Chi-square, Mann-Whitney U test, and logistic regression.

Results: Groups did not differ significantly by MS status, age, gender, ethnicity or insurance. Subjects with MS had lower self-reported mobility scores (p=0.000) and higher fatigue scores (p=0.002) than those without MS. Seventy-nine percent of participants adhered to assigned DBS protocol. Adherence did not differ between groups or MS status. Seventy-five percent rated DBS collection as convenient and easy, and were likely to recommend the method to others. However, Group A experienced more pain and difficulty pricking their fingers than Group B (p < 0.05), and subjects with MS had more difficulty filling the DBS kit (p<0.05). Fatigue score was positively associated with pain (p<0.04), while higher anxiety was related to difficulty collecting the sample (p<0.001) after controlling for MS status and age.

Conclusions: At-home DBS sampling appears to be acceptable to patients, and may be a viable and preferred method for tracking biomarkers. Although frequency did not impact adherence in this study, increasing intervals between tests could improve comfort and convenience. Patients with MS and patients with anxiety about blood collection may require additional support.