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. 2023 Aug 31:11:1245089.
doi: 10.3389/fchem.2023.1245089. eCollection 2023.

Noninvasive drug adherence monitoring of antipsychotic patients via finger sweat testing

K Longman  1 , C Frampas  1 , H Lewis  1 , C Costa  2 , R Nilforooshan  3   4 , M Chambers  4 , M Bailey  1
Affiliations

Noninvasive drug adherence monitoring of antipsychotic patients via finger sweat testing

K Longman et al. Front Chem. .

Abstract

Collection of finger sweat is explored here as a rapid and convenient way of monitoring patient adherence to antipsychotic drugs. Finger sweat samples (n = 426) collected from patients receiving treatment with clozapine, quetiapine and olanzapine were analysed by liquid chromatography mass spectrometry, including a subgroup of patients with paired plasma samples. Finger sweat samples were also analysed from a negative control group and patients who had handled antipsychotic medication only. The finger sweat test (based on the detection of parent drug in one donated sample) was 100% effective in monitoring adherence within commonly prescribed dosing ranges. In comparison to participants who handled the medication only, the test could distinguish between contact and administration through monitoring of the drug metabolite, or the level of parent drug. Additionally, in a subgroup of patients prescribed clozapine, a statistically significant correlation was observed between the mass of parent drug in finger sweat and plasma concentration. The finger sweat technology shows promise as a dignified, noninvasive method to monitor treatment adherence in patients taking antipsychotics.

Keywords: adherence; antipsychotic; finger sweat; liquid chromatography mass spectrometry; noninvasive.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Sample collection procedure. Finger sweat samples collected (1) “as presented” and (2) “after washing”. Created using Biorender.com.
FIGURE 2
FIGURE 2
Ratio of metabolite/parent drug in finger sweat samples collected (A) “as presented” and (B) “after washing” for clozapine users prescribed ≥100 mg/day (n = 32 participants, labelled “drug user”) and volunteers (N = 2) which held antipsychotic tablet in right hand (labelled “tablet”) and rubbed crushed tablet in left hand (labelled “powder”).
FIGURE 3
FIGURE 3
Ratio of metabolite/parent drug in finger sweat samples collected (A) “as presented” and (B) “after washing” for quetiapine users (n = 7 participants, labelled “drug user”) and volunteers (N = 2) which held antipsychotic tablet in right hand (labelled “tablet”) and rubbed crushed tablet in left hand (labelled “powder”).
FIGURE 4
FIGURE 4
Comparison of mass in finger sweat collected “after washing” versus plasma concentration for (A) clozapine and (B) N-desmethylclozapine.
FIGURE 5
FIGURE 5
Pearson correlation coefficient (r) and p-value (P) (1-tailed) for the mass of clozapine in finger sweat collected “after washing” from the middle and ring fingers and clozapine concentration in paired plasma samples.
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