Keywords: Capillary self-blood collection, Chronic disease management, Remote monitoring, Rural primary care

Background:

Patients with chronic conditions require regular blood monitoring, posing logistical challenges, particularly in rural areas. Long travel distances burden patients and healthcare systems. Capillary self-blood collection (SBC) with mail shipment could enhance continuity of care by reducing in-person visits while maintaining reliable laboratory monitoring. However, feasibility regarding pain perception, usability, and analytical reliability under postal conditions remains insufficiently investigated in general practice populations.

Research questions:

Is capillary self-blood collection with mail shipment feasible for general practice patients in terms of comparable analytical quality to venous blood draws and usability?

Method:

Cross-sectional study including 106 participants from two rural German general practices. Participants performed capillary SBC using the Tasso+® upper-arm device during routine blood draw appointments. Each participant provided three samples: one capillary sample and two venous samples from the same access, one mailed and one transported by courier. We assessed pain perception, usability (System Usability Scale), blood volume yield, and concordance of laboratory parameters (HbA1c, lipid panel, creatinine, liver enzymes, CRP, ferritin, TSH). Transport characteristics were logged.

Results:

More than half of participants (57.5%) performed SBC without assistance and 59.4% achieved sufficient blood volumes (≥130μL plasma). SBC caused significantly less pain than venipuncture. High usability was reported, with over three-quarters of participants achieving System Usability Scale scores ≥80. Comparison of mailed versus couriered venous samples demonstrated high concordance, confirming minimal impact of postal transport on sample quality. Similarly, high concordance was observed between capillary and venous samples for clinically relevant laboratory parameters.

Conclusions:

Capillary SBC with mail shipment is feasible in general practice and provides analytical quality comparable to venous blood draws. This approach can enhance continuity of care by reducing routine blood draw appointments and patient burden, particularly in rural settings. Despite higher current costs, SBC enables remote monitoring for chronic disease management and supports multicenter research.

Points for discussion:

How can self-blood collection systems be integrated into existing primary care workflows to enhance continuity of care?

Which patient populations would benefit most from remote blood monitoring via SBC?

What implementation strategies could improve usability for patients with lower educational levels or digital literacy?