General Health Screening and Drug Monitoring

General health screening involves blood and urine testing without specific symptoms present. This preventive screening can identify risk factors and potential diseases in an early stage, allowing timely intervention through treatment or lifestyle modifications to delay or prevent disease progression.

Drug monitoring measures medication and/or drug metabolite levels in blood. These measurements enable optimization of dosage and treatment effectiveness.

In vitro diagnostics

The following examples illustrate how laboratory testing contributes to preventive health screening and therapeutic drug monitoring.

In vitro diagnostics

• Medication monitoring

  The effectiveness and side effects of many medications depend on individual absorption and breakdown rates. This pharmacokinetics varies between individuals. Genetic variations result in "fast" and "slow" metabolizers. Kidney and liver function also play important roles. These individual differences lead to variations in therapeutic response and side effects. By monitoring blood drug levels (therapeutic drug monitoring), medication type and dosage can be adjusted appropriately.

  Biologics

  Biologics represent a new class of medications derived from animal or human proteins. They are used to treat inflammatory conditions such as rheumatoid arthritis and certain gastrointestinal and skin diseases by inhibiting inflammatory proteins and cells. These expensive medications can elicit varying individual responses. Although they closely resemble human proteins, they may still be recognized as foreign and trigger an immune response. Antibody formation can neutralize the biologic's effectiveness. Medication monitoring can track how and whether an individual responds to biologic treatment.

  Remote monitoring is available through finger-prick blood testing. Using a special test kit, blood samples can be collected at home and sent to the laboratory. The lab measures both the amount of biologic in the blood and the antibody response. Based on these measurements, dosage can be adjusted promptly. Medication monitoring is essential for cost-effective use of expensive biologics.

• Pregnancy testing

  Pregnant women considering screening their unborn child for Down, Edwards, and Patau syndromes can opt for non-invasive prenatal testing (NIPT), a safe alternative to amniocentesis. This blood test has been part of standard prenatal screening programs in the Netherlands since April 2013.

  NIPT

  NIPT is a blood test that screens for chromosomal abnormalities in the unborn child indicating Down syndrome (trisomy 21), Edwards syndrome (trisomy 18), or Patau syndrome (trisomy 13). The test analyzes cell-free fetal DNA present in maternal blood via the placenta. It measures relative quantities of chromosomes or chromosome segments in maternal plasma, analyzing results through an algorithm. NIPT can be performed starting at ten weeks of pregnancy.

• Antibiotic resistance

  Excessive antibiotic use has led to increasing bacterial resistance to antibiotics. Combating resistance requires prudent and responsible antibiotic use. Strict hygiene measures in hospitals and nursing homes are also important. However, even with careful policies, resistant bacterial strains can enter through foreign hospitals or intensive livestock farming. The MDRO test is an essential tool for screening suspected presence of MultiDrug-Resistant Organisms (MDROs).

  MDRO screening

  Hospital patients are screened for MultiDrug-Resistant Organisms (MDROs) if they have recently been treated in foreign hospitals or work in intensive livestock farming. Patient samples (anal, sputum, wound fluid, or urine) are collected using swabs and analyzed for microorganism presence. Detection and identification utilize PCR technology and DNA analysis. This method determines within 24 hours whether a patient carries an MDRO and identifies the specific type.

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