Journal of Drug Metabolism & Toxicology
Open Access

Advancements in Point-of-Care Testing for Rapid Assessment of Therapeutic Drug Levels

Boizena Aris^{* *}Correspondence: Boizena Aris, Department of Medicine, Federal University of Para, Para, Brazil, Email:

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Description

The emergence and evolution of Point-of-Care Testing (POCT) have revolutionized the landscape of clinical diagnostics, offering rapid, accessible and often portable solutions for patient monitoring. One of the most promising frontiers in this domain is the real-time measurement of therapeutic drug levels, which has significant implications for personalized medicine, drug safety, and treatment optimization.

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug concentrations in a patient's bloodstream to ensure optimal dosing, maximize efficacy, and minimize toxicity. Traditionally, TDM relies on centralized laboratory techniques like High-Performance Liquid Chromatography (HPLC) or mass spectrometry, which, while accurate, are time-consuming and require complex instrumentation. Delays in obtaining results can hinder timely decision-making in critical care, emergency settings, and outpatient management.

Recent advances in POCT technologies have addressed many of these limitations by developing miniaturized, user-friendly, and highly sensitive devices that deliver near-instantaneous drug level results. These platforms include biosensors, immunoassays, lab-on-a-chip systems, and electrochemical detectors, which are often integrated with smartphones or portable readers. Such innovations allow clinicians to assess drug concentrations at the patient’s bedside, in ambulatory clinics, or even at home facilitating real-time dosage adjustments.

One area where the therapeutic drugs has shown particular promise is in antimicrobial stewardship. For instance, aminoglycosides and vancomycin antibiotics with narrow therapeutic windows can now be monitored rapidly to avoid nephrotoxicity and maintain efficacy. Similarly, anti-epileptics, immunosuppressants (e.g., tacrolimus, cyclosporine) and chemotherapeutic agents require precise dosing, and POCT enables more responsive titration in these cases.

Nanotechnology and microfluidics have played a transformative role in advancing POCT for TDM. These technologies enable the manipulation of small fluid volumes and detection of low-abundance analytes, reducing the required sample size sometimes just a drop of blood from a finger prick. Additionally, Paper-based Analytical Devices (Pads) and lateral flow immunoassays offer cost-effective, disposable solutions for resource-limited settings.

Another significant innovation is the integration of digital health tools and wireless data transmission, allowing test results to be shared instantly with healthcare providers or stored in electronic health records. This connectivity enhances continuity of care, particularly for chronic disease patients on long-term drug therapy. Moreover, the use of machine learning algorithms in some platforms can interpret POCT data and provide clinical decision support in real time.

Despite these advances, several challenges persist. Ensuring analytical accuracy and reproducibility across POCT devices remains a top priority. Unlike centralized laboratories that operate under stringent quality control measures, POCT must maintain performance under diverse conditions. Regulatory frameworks, including FDA approval and CE marking, are crucial for validating these technologies before clinical deployment. Furthermore, cost-effectiveness, user training, and integration into existing healthcare workflows are critical considerations for broader adoption.

In the future, it is anticipated that multiplexed POCT platforms capable of simultaneously measuring drug levels and relevant biomarkers (e.g., renal function, liver enzymes) will emerge, providing a more holistic view of pharmacotherapy and patient status. This will further support precision dosing and move clinical care toward a more individualized, responsive model.

Conclusion

The advancement of point-of-care testing for the rapid assessment of therapeutic drug levels represents a paradigm shift in personalized medicine. By providing immediate, accurate, and actionable data, POCT enhances clinical decision-making, especially in time-sensitive scenarios. These technologies bridge the gap between diagnosis and intervention, supporting safer and more effective drug administration. As innovation continues to refine these tools through enhanced sensitivity, connectivity and user experience their integration into routine clinical practice is poised to improve patient outcomes and redefine therapeutic monitoring in the 21st century.