LAUSR

BACKGROUND Minimally invasive sampling methods are important to facilitate therapeutic drug monitoring (TDM) and pharmacokinetic research in children with behavioral problems. This study assessed the feasibility and pain of dried blood spot (DBS) sampling in this population. METHODS Repeated DBS sampling was performed in children with autism spectrum disorder (ASD) and severe behavioral problems, aged between 6 and 18 years. The child, guardian, and DBS performer assessed pain using the numeric rating scale (NRS-11) or 5-face Faces Pain Scale. The influence of age, sex, and the fingerprick performer on the child's pain intensity was analyzed using linear mixed models. RESULTS Overall, 247 fingerpricks were performed in 70 children. Seven children refused all DBS sampling. The median (IQR) NRS-11 pain scores were 2 (3) rated by children, 3 (2.5) by guardians, and 2 (2) by fingerprick performers. The child's age and sex, and fingerprick performer had no significant influence on pain intensity. CONCLUSIONS DBS sampling could be performed in most children with ASD and severe behavioral problems. However, 1 in 5 children refused one or more DBS fingerpricks owing to distress. The majority expressed minimal pain (NRS <4). Repeated sampling with DBS is feasible in children with ASD and severe behavioral problems.