Ethical Dimensions of Disparities in Depression Research and Treatment in the Pharmacogenomic Era

Parker, Lisa S.; Satkoske, Valerie

doi:10.1111/j.1748-720x.2012.00718.x

Cited by 7 publications

(6 citation statements)

References 47 publications

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“…However, psychiatrists (with the second largest number of approved FDA biomarkers) have not fully embraced PGx testing in clinical practice. 16,17 In addition, consistent with Parker and Satkoske, 18 the FDA acknowledges that one key limitation of these labels is that the efficacy of PGx has not been established with minority populations. 12 Moreover, due to the history of the United States government conducting unethical medical experimentation under the guise of clinical trials and treatment with these populations, 18 such efficacy testing is likely to be a sensitive issue.…”

Section: Considerations For Pgx Clinical Usementioning

confidence: 83%

“…16,17 In addition, consistent with Parker and Satkoske, 18 the FDA acknowledges that one key limitation of these labels is that the efficacy of PGx has not been established with minority populations. 12 Moreover, due to the history of the United States government conducting unethical medical experimentation under the guise of clinical trials and treatment with these populations, 18 such efficacy testing is likely to be a sensitive issue. This will undoubtedly contribute to the slow adoption of PGx among minority groups.…”

Section: Considerations For Pgx Clinical Usementioning

confidence: 83%

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Landmarks of pharmacogenomics and some considerations for clinical practice

Ampong

2019

Therapeutic Advances in Psychopharmacology

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Since the completion of the Human Genome Project 28 years ago, myriad genomics applications have risen in areas such as agriculture, livestock, infectious agents, forensics, bioenergy, ancestry, health, disease, and medicine. This was driven partly by the US government’s ability to use a unique program to facilitate genome sequencing to the point where the cost of sequencing a whole human genome is not prohibitive. However, application of this knowledge of the double helix twisted DNA at the bedside in psychiatric clinical practice has little to report, despite US Food and Drug Administration (FDA) approval of nearly 40 psychotropic drugs, as well as specific guidelines for their application. Patients with treatment-resistant mental illness, history of unresponsiveness to psychotropic medications, and history or family history of serious adverse effects to psychotropic drugs may qualify for pharmacogenomics (PGx) testing with insurance reimbursement, or a low, out-of-pocket, payment of not greater than US $300. Psychiatric mental health nurse practitioners and providers who utilize PGx will not only improve patient care outcomes, but also contribute to the acceleration of the potential diagnostic and preventive capabilities of PGx testing.

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Section: Considerations For Pgx Clinical Usementioning

confidence: 83%

Section: Considerations For Pgx Clinical Usementioning

confidence: 83%

Landmarks of pharmacogenomics and some considerations for clinical practice

Ampong

2019

Therapeutic Advances in Psychopharmacology

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“…Failure to account for these differences can lead to the development of pharmacologic treatment strategies for nicotine dependence that do not perform equally well in all smokers making a quit attempt ( Goodman & Brett, 2021 ; Nollen et al, 2021 ). This in turn may exacerbate health disparities in smoking cessation across racial and ethnic groups ( Parker & Satkoske, 2012 ; Smart et al, 2004 ). Genomic studies of the pharmacological responses for smoking cessation are beginning to disaggregate the societal contexts of race and ethnicity from the differences in allele distribution across genetic loci by including data across multiple genetic ancestry groups.…”

Section: Introductionmentioning

confidence: 99%

A scoping review of smoking cessation pharmacogenetic studies to advance future research across racial, ethnic, and ancestral populations

Prom-Wormley,

Wells,

Landes

et al. 2023

Front. Genet.

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Abstinence rates among smokers attempting to quit remain low despite the wide availability and accessibility of pharmacological smoking cessation treatments. In addition, the prevalence of cessation attempts and abstinence differs by individual-level social factors such as race and ethnicity. Clinical treatment of nicotine dependence also continues to be challenged by individual-level variability in effectiveness to promote abstinence. The use of tailored smoking cessation strategies that incorporate information on individual-level social and genetic factors hold promise, although additional pharmacogenomic knowledge is still needed. In particular, genetic variants associated with pharmacological responses to smoking cessation treatment have generally been conducted in populations with participants that self-identify as White race or who are determined to be of European genetic ancestry. These results may not adequately capture the variability across all smokers as a result of understudied differences in allele frequencies across genetic ancestry populations. This suggests that much of the current pharmacogenetic study results for smoking cessation may not apply to all populations. Therefore, clinical application of pharmacogenetic results may exacerbate health inequities by racial and ethnic groups. This scoping review examines the extent to which racial, ethnic, and ancestral groups that experience differences in smoking rates and smoking cessation are represented in the existing body of published pharmacogenetic studies of smoking cessation. We will summarize results by race, ethnicity, and ancestry across pharmacological treatments and study designs. We will also explore current opportunities and challenges in conducting pharmacogenomic research on smoking cessation that encourages greater participant diversity, including practical barriers to clinical utilization of pharmacological smoking cessation treatment and clinical implementation of pharmacogenetic knowledge.

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“…14,15,16,17 Poorer outcomes following depression treatment were also found when comparing African Americans to non-Hispanic whites. 18,19 These findings demonstrate the importance of providing culturally and socially appropriate treatment interventions for patients.…”

mentioning

confidence: 98%

Characterizing Depression and Comorbid Medical Conditions in African American Women in a Primary Care Setting

Shim

Baltrus

Bradford

et al. 2013

Journal of the National Medical Association

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Background African American women are more likely to seek treatment for depression in primary care settings; however, few women receive guideline-concordant depression treatment in these settings. This investigation focused on the impact of depression on overall functioning in African American women in a primary care setting. Methods Data was collected from a sample of 507 African American women in the waiting room of an urban primary care setting. The majority of women were well-educated, insured, and employed. The CESD-R was used to screen for depression, and participants completed the 36-Item Short-Form Survey to determine functional status. Results Among the participants with depression, there was greater functional impairment for role-physical (z = −0.88, 95% CI = −1.13, −0.64) when compared to individuals with diabetes and hypertension. Individuals with depression also had greater role-emotional impairment (z=−1.12, 95% CI = −1.37, −0.87) than individuals with diabetes and hypertension. African American women with comorbid hypertension and depression had greater functional impairment in role-physical when compared to African American women with hypertension and no depression (t(124)= −4.22, p<0.01). Conclusion African American women with depression are more likely to present with greater functional impairment in role function when compared to African American women with diabetes or hypertension. Because African American women often present to primary care settings for treatment of mental illness, primary care providers need to have a clear understanding of the population, as well as the most effective and appropriate interventions.

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Ethical Dimensions of Disparities in Depression Research and Treatment in the Pharmacogenomic Era

Cited by 7 publications

References 47 publications

Landmarks of pharmacogenomics and some considerations for clinical practice

Landmarks of pharmacogenomics and some considerations for clinical practice

A scoping review of smoking cessation pharmacogenetic studies to advance future research across racial, ethnic, and ancestral populations

Characterizing Depression and Comorbid Medical Conditions in African American Women in a Primary Care Setting

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