Wireless, noninvasive therapeutic drug monitoring system for saliva measurement toward medication management of schizophrenia

As an efficient patient management tool of precision medicine, decentralized therapeutic drug monitoring (TDM) provides new vision for therapy adherence and health management of schizophrenia in a convenient manner. To dispense with psychologically burdensome blood sampling and to achieve real-time, noninvasive, and continual circulating tracking of drugs with narrow therapeutic window, we study the temporal metabolism of clozapine, an antipsychotic with severe side effect, in rat saliva by a wireless, integrated and patient-friendly smart lollipop sensing system. Highly sensitive and efficient sensing performance with acceptable anti-biofouling property was realized based on the synergistic effect of electrodeposited reduced graphene oxide and ionic liquids in pretreatment-free saliva with low detection limit and good accuracy cross-validated with conventional method. On this basis, continual salivary drug levels with distinctive pharmacokinetics were found in different routes of drug administration. Pilot experiment reveals a strong correlation between blood and saliva clozapine and a positive relationship between drug dosage and salivary drug level, indicating potential applications presented by noninvasive saliva analysis towards patient-centered and personalized pharmacotherapy and adherence man-agement via proposed smart lollipop system.

Automated summary

As an efficient patient management tool, decentralized therapeutic drug monitoring provides new possibilities for adherence and health management in schizophrenia. A wireless smart lollipop system was used to study the temporal metabolism of clozapine in rat saliva, providing real-time, noninvasive drug tracking. The system achieved highly sensitive and efficient sensing performance, allowing continual salivary drug level monitoring with distinctive pharmacokinetics for different routes of drug administration. This noninvasive saliva analysis system has the potential for patient-centered and personalized pharmacotherapy and adherence management.