module 1:
remote therapeutic drug monitoring (TDM) 

This is the first module in a series that covers remote patient monitoring (RPM).

you can use remote technologies for therapeutic drug monitoring (TDM) 

Therapeutic drugs benefit patients in many disease areas, including kidney disease, organ transplants, oncology, autoimmune disorders, neurology and mental health. While beneficial, therapeutic drugs require close monitoring to guard against toxicity and ensure efficacy.

Therapeutic drug monitoring, or TDM, typically involves frequent visits to the clinic or lab for blood draws and tests to check drug levels, which can become burdensome for patients. Remote blood collection is a convenient alternative to clinic visits. It allows patients to collect their own blood samples at home for mailing to the lab for testing. Clinicians can access lab results securely online to track therapeutic drug levels for patients remotely. Remote blood collection paired with virtual communications and other telehealth technologies can reduce or replace in-clinic TDM. Explore this page for information on how remote microsampling simplifies TDM for patients and providers.

remote therapeatuic monitoring device held by doctor in front of screen blue purple gradient with doctor on phone

conditions that benefit from
therapeutic drugs

Allergies

Allergy treatment can include immunotherapy, which involves exposure to certain allergens in increasing doses over time to improve tolerance and reduce symptoms. Immunotherapy shots are given under medical observation for safety.

Autoimmune Diseases

Autoimmune disorders can respond well to immunosuppressive therapy, including drugs such as methotrexate, sirolimus, and cyclophosphamide. Anti-inflammatory agents, such as corticosteroids, may also be used.

Cancers

Cancer can be treated with targeted therapy using drugs that attack specific cancer cells, or with immunotherapy using drugs that stimulate the immune system to recognize cancer cells as foreign bodies and attack them.

Kidney Disease

Reduced renal function requires drug therapy for associated conditions. Since most drugs are excreted by the kidneys, drug dosage must be monitored and adjusted to avoid toxicity and ensure efficacy for patients with kidney disease.

Mood Disorders

Some therapeutic drugs act as mood stabilizers for mood disorders as defined in the DSM-5. Medications that help control manic or hypomanic episodes include lithium, valproic acid, divalproex sodium, and carbamazepine.

Organ Transplants

Immunosuppressive therapy is necessary for organ transplant patients to ensure their bodies don't reject the transplant. TDM manages levels of calcineurin inhibitors (tacrolimus), cytotoxic immunosuppressants and corticosteroids.

therapeutic drugs to monitor

Antibiotics

Anti-Cancer Agents

Anti-Epileptics

Immunosuppressants

Mood Stabilizers, Anti-Depressants, Anti-Psychotics

Anti-Retroviral Agents & Other Biological Agents

Antibiotics

Antibiotics - Printed Diagnosis with Blurred Text. On Background of Medicaments Composition - Red Pills, Injections and Syringe.

TDM is required for many patients on antibiotics like aminoglycosides or glycopeptides (e.g., vancomycin). Remote patient monitoring helps manage blood concentration levels and dosing to prevent drug toxicity and ensure efficacy. Patients can use Mitra® devices for remote TDM. They self-collect blood samples and send them to the lab for testing. This is an economical alternative to cold-chain transportation of plasma specimens. To learn about a study that used this approach:Read More

Anti-Cancer Agents

Cancer Treatment - Medical Concept with Red Pills, Injections and Syringe. Selective Focus. 3D Render.

Therapeutic drug monitoring is important for cancer patients taking tyrosine kinase inhibitors (TKIs). These chemotherapy medications inhibit one or more of the enzyme tyrosine kinases. One example is rituximab, a targeted cancer drug known by the brand names MabThera®, Rixathon® and Truxima®. To learn how Mitra® was investigated as a blood sampling alternative that enables remote TDM of these drugs:Read More

Another study investigated the use of Mitra for remotely monitoring trastuzumab (Herceptin®), used to treat breast cancer and stomach cancer:Read More

Anti-Epileptics

A male doctor in white coat with a stethoscope holding a pill with glowing colorful dots and lines

Drug interactions can occur between anti-epileptic drugs (AEDs), so routine blood sampling for TDM is critical to avoid adverse interactions and side effects. Dosage adjustment of anti-epileptic drugs by TDM is also important, especially for the first-generation anti-epileptic drugs. Microsampling—the collection of small volumes of blood—is increasingly considered a valuable alternative to conventional venous blood sampling for TDM:Read More

Immunosuppressants / Immunosuppressive Drugs

immunosuppressants-drug-detection-dried-blood

TDM for patients on immunosuppressive drugs (e.g., tracrolimus, cyclosporine) usually requires outpatient travel for frequent venous blood draws at the clinic or blood draw center. However, remote microsampling allows self-collection at home, and shipping of blood samples to a laboratory for analysis. This remote TDM option results in a high level of patient satisfaction. Studies show that Mitra with VAMS technology enables validated lab testing and delivers accurate results that help the TDM care team make informed decisions:Read More

Mood Stabilizers, Anti-Depressants, Anti-Psychotics

Diagnosis - Schizophrenia. Medical Concept with Red Pills, Injections and Syringe. Selective Focus. 3D Render.

Mental health patients may be prescribed mood stabilizers, such as lithium or valproic acid. Other therapeutics include anti-psychotics like pimozide or clozapine. Patients taking these drugs must be monitored. Remote monitoring is possible with devices that allow patients to self-collect a capillary blood sample at home. To interpret capillary blood concentrations with current therapeutic reference ranges, conversion factors must be established with clinical validation studies, such as this one:Read More

Anti-Retroviral Agents & Other Biological Agents

HIV - Printed Diagnosis with Blurred Text. On Background of Medicaments Composition - Red Pills, Injections and Syringe.

Antiretroviral drugs are used to treat retroviruses, primarily HIV-1. Patients usually receive a combination of these drugs for highly active anti-retroviral therapy (HAART). The drugs include delavirdine, doravirine, efavirenz, etravirine, and rilpivirine, among others. TDM is needed to monitor patients for adverse effects, strength of the immune system, and reduction of viral load. Ritonavir (RTV, Norvir®), is a protease inhibitor antiretroviral medication that is used in combination with others to treat HIV/AIDS:Read More

learn more about patient-centric blood sampling for remote TDM 

Join a growing network of leaders in science and healthcare who are using remote care pathways to improve the patient journey, as well as patient outcomes. We take pride in providing patient-friendly, quantitative remote blood collection devices that not only facilitate safe and convenient telehealth care pathways, but also enable clinical labs to report accurate results from capillary blood samples.

We believe that patient-centric microsampling is the wave of the future, and with our Mitra® microsampler with VAMS® technology, we are helping our customers ride the crest of that wave. With more than 100 publications testifying to its value in the clinic, lab, or field, Mitra microsampling devices are the trusted choice of clinical researchers, lab directors, physicians, patients, and healthcare decision-makers around the globe.

TDM resource library

Learn how to take TDM out of the clinic with the ultimate resource library for therapeutic drug monitoring.

Get instant access to: 

  • Case Studies
  • eBooks & Guides
  • Research Papers
  • Method Development & Validation
  • Videos, Tutorials, and More!

download our TDM remote therapeutic drug monitoring resource library bundle

TDM goes mobile!
Comfort, Convenience, Continuity of Care

Remote blood sampling at home or on-the-go simplifies therapeutic drug monitoring, making it more comfortable and convenient. Patients taking therapeutic drugs, such as immunosuppressants, don't always need to visit the clinic or lab for blood draws and testing. A special program in the UK provides blood collection kits patients can use to collect their own blood at home or work at scheduled intervals. Patients mail their samples to the lab for testing, and timely lab results are accessible to the TDM care team remotely for follow-up.

ready to learn more about TDM and remote care pathways?

Sign-up to receive more information on therapeutic drug monitoring and other areas of remote patient monitoring (RPM). We’re adding new resource modules to our series, which cover different aspects of RPM to keep you informed of changes and updates. Below is a preview of some of the resource modules we have lined up. Be sure to check back soon for updates via our main RPM page

Module 1 | Therapeutic Drug Monitoring: Immunosuppressants, Hormones, etc.

(Hydroxychloroquine, IGF-1, Methotrexate, Anti-epileptics, Anti-depressants, Anti-psychotics, Tacrolimus, etc.)

Therapeutic drugs benefit patients in a range of disease areas, including kidney disease & transplants, oncology, autoimmune disorders, neurology, mental health, and more. At-home blood collection allows patients and their care team to remotely track therapeutic drug levels for optimal efficacy—something that typically requires frequent follow-up. Remote blood collection keeps vulnerable patients safe at home and reduces unnecessary travel. You are currently viewing this module.

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