Pharmacogenetics in Practice: Estimating the Clinical Actionability of Pharmacogenetic Testing in Perioperative and Ambulatory Settings.

MedStar author(s):
Citation: Clinical and translational science. 13(3):618-627, 2020 05.PMID: 31961467Institution: MedStar Health | MedStar Heart & Vascular Institute | MedStar Union Memorial Hospital | MedStar Washington Hospital Center | SiTELDepartment: Anesthesiology | Associate Dean for Research Development | Chief Medical Information Officer | PharmacogenomicsForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Ambulatory Care/sn [Statistics & Numerical Data] | *Perioperative Care/sn [Statistics & Numerical Data] | *Pharmacogenomic Testing/sn [Statistics & Numerical Data] | *Practice Patterns, Physicians'/sn [Statistics & Numerical Data] | *Precision Medicine/sn [Statistics & Numerical Data] | Aged | Ambulatory Care/st [Standards] | District of Columbia | Female | Humans | Male | Maryland | Middle Aged | Perioperative Care/st [Standards] | Pharmacogenomic Testing/st [Standards] | Pilot Projects | Practice Guidelines as Topic | Practice Patterns, Physicians'/st [Standards] | Precision Medicine/mt [Methods] | Precision Medicine/st [Standards] | Retrospective Studies | United States | United States Food and Drug Administration/st [Standards]Year: 2020ISSN:
  • 1752-8054
Name of journal: Clinical and translational scienceAbstract: Most literature describing pharmacogenetic implementations are within academic medical centers and use single-gene tests. Our objective was to describe the results and lessons learned from a multisite pharmacogenetic pilot that utilized panel-based testing in academic and non-academic settings. This was a retrospective analysis of 667 patients from a pilot in four perioperative and five outpatient cardiology clinics. Recommendations related to 12 genes and 65 drugs were classified as actionable or not actionable. They were ascertained from Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines and U.S. Food and Drug Administration (FDA) labeling. Patients displayed a high prevalence of actionable results (88%, 99%) and use of medications (28%, 46%) with FDA or CPIC recommendations, respectively. Sixteen percent of patients had an actionable result for a current medication per CPIC compared to 5% per FDA labeling. A systematic approach by a health system may be beneficial given the quantity and diversity of patients affected. Copyright (c) 2020 The Authors. Clinical and Translational Science published by Wiley Periodicals, Inc. on behalf of the American Society for Clinical Pharmacology and Therapeutics.All authors: Brown RP, Eldadah Z, Hwang E, Kmiecik S, Levin B, Lundergan C, McAlduff J, Peshkin BN, Shapiro R, Smith DM, Springfield TB, Swain SMOriginally published: Clinical and translational science. 2020 Jan 21Fiscal year: FY2020Digital Object Identifier: Date added to catalog: 2020-02-10
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Journal Article MedStar Authors Catalog Article 31961467 Available 31961467

Most literature describing pharmacogenetic implementations are within academic medical centers and use single-gene tests. Our objective was to describe the results and lessons learned from a multisite pharmacogenetic pilot that utilized panel-based testing in academic and non-academic settings. This was a retrospective analysis of 667 patients from a pilot in four perioperative and five outpatient cardiology clinics. Recommendations related to 12 genes and 65 drugs were classified as actionable or not actionable. They were ascertained from Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines and U.S. Food and Drug Administration (FDA) labeling. Patients displayed a high prevalence of actionable results (88%, 99%) and use of medications (28%, 46%) with FDA or CPIC recommendations, respectively. Sixteen percent of patients had an actionable result for a current medication per CPIC compared to 5% per FDA labeling. A systematic approach by a health system may be beneficial given the quantity and diversity of patients affected. Copyright (c) 2020 The Authors. Clinical and Translational Science published by Wiley Periodicals, Inc. on behalf of the American Society for Clinical Pharmacology and Therapeutics.

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