Landmarks of pharmacogenomics and some considerations for clinical practice

Ampong, David Nana

doi:10.1177/2045125319896650

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…Following resolution of any discrepancies between reviewers, 83 publications were included in the final review (ordered alphabetically by primary author in Table 1). 8–90 A flow diagram tracking the number of studies at each stage of the selection process is presented in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Of the eighty‐three publications included in the review (Table 1), 8–90 seventy‐five (90.4%) were published since 2010 inclusive, and 48 (57.8%) since 2016 inclusive (Figure 2). The majority of studies were carried out in the United States ( n = 66; 79.5%), followed by the United Kingdom ( n = 5; 6.0%), Canada ( n = 3; 3.6%), and Australia ( n = 2; 2.4%) (Figure S1).…”

Section: Resultsmentioning

confidence: 99%

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Out‐of‐pocket and private pay in clinical genetic testing: A scoping review

et al. 2021

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Full coverage of the cost of clinical genetic testing is not always available through public or private insurance programs, or a public healthcare system. Consequently, some patients may be faced with the decision of whether to finance testing out-ofpocket (OOP), meet OOP expenses required by their insurer, or not proceed with testing. A scoping review was conducted to identify literature associated with patient OOP and private pay in clinical genetic testing. Seven databases (EMBASE, MEDLINE, CINAHL, PsychINFO, PAIS, the Cochrane Database of Systematic Reviews, and the JBI Evidence-Based Practice database) were searched, resulting in 83 unique publications included in the review. The presented evidence includes a descriptive analysis, followed by a narrative account of the extracted data. Results were divided into four groups according to clinical indication: (1) hereditary breast and ovarian cancer, (2) other hereditary cancers, (3) prenatal testing, (4) other clinical indications. The majority of studies focused on hereditary cancer and prenatal genetic testing. Overall trends indicated that OOP costs have fallen and payer coverage has improved, but OOP expenses continue to present a barrier to patients who do not qualify for full coverage.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Out‐of‐pocket and private pay in clinical genetic testing: A scoping review

et al. 2021

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“…The events leading to the emergence of PGx in psychiatry began in ancient Greece and has been described in detail elsewhere (Ampong, 2019; Müller & Rizhanovsky, 2020). In brief, the Greek scientist Pythagoras described an adverse reaction, now known as acute hemolytic anemia, that was experienced by some, but not all, people who consumed fava beans.…”

Section: Emergence Of Pgx In Psychiatrymentioning

confidence: 99%

The emergence, implementation, and future growth of pharmacogenomics in psychiatry: a narrative review

Bousman,

Maruf,

Marques

et al. 2023

Psychol. Med.

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Psychotropic medication efficacy and tolerability are critical treatment issues faced by individuals with psychiatric disorders and their healthcare providers. For some people, it can take months to years of a trial-and-error process to identify a medication with the ideal efficacy and tolerability profile. Current strategies (e.g. clinical practice guidelines, treatment algorithms) for addressing this issue can be useful at the population level, but often fall short at the individual level. This is, in part, attributed to interindividual variation in genes that are involved in pharmacokinetic (i.e. absorption, distribution, metabolism, elimination) and pharmacodynamic (e.g. receptors, signaling pathways) processes that in large part, determine whether a medication will be efficacious or tolerable. A precision prescribing strategy know as pharmacogenomics (PGx) assesses these genomic variations, and uses it to inform selection and dosing of certain psychotropic medications. In this review, we describe the path that led to the emergence of PGx in psychiatry, the current evidence base and implementation status of PGx in the psychiatric clinic, and finally, the future growth potential of precision psychiatry via the convergence of the PGx-guided strategy with emerging technologies and approaches (i.e. pharmacoepigenomics, pharmacomicrobiomics, pharmacotranscriptomics, pharmacoproteomics, pharmacometabolomics) to personalize treatment of psychiatric disorders.

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Multidisciplinary Consulting Team for Complicated Cases of Neurodevelopmental and Neurobehavioral Disorders: Assessing the Opportunities and Challenges of Integrating Pharmacogenomics into a Team Setting

Gill

Elchynski

Porter-Gill

et al. 2022

JPM

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Neurodevelopmental disorders have steadily increased in incidence in the United States. Over the past decade, there have been significant changes in clinical diagnoses and treatments some of which are due to the increasing adoption of pharmacogenomics (PGx) by clinicians. In this pilot study, a multidisciplinary team at the Arkansas Children’s Hospital North West consulted on 27 patients referred for difficult-to-manage neurodevelopmental and/or neurobehavioral disorders. The 27 patients were evaluated by the team using records review, team discussion, and pharmacogenetic testing. OneOme RightMed® (Minneapolis, MN, USA) and the Arkansas Children’s Hospital comprehensive PGx test were used for drug prescribing guidance. Of the 27 patients’ predicted phenotypes, the normal metabolizer was 11 (40.8%) for CYP2C19 and 16 (59.3%) for CYP2D6. For the neurodevelopmental disorders, the most common comorbid conditions included attention-deficit hyperactivity disorder (66.7%), anxiety disorder (59.3%), and autism (40.7%). Following the team assessment and PGx testing, 66.7% of the patients had actionable medication recommendations. This included continuing current therapy, suggesting an appropriate alternative medication, starting a new therapy, or adding adjunct therapy (based on their current medication use). Moreover, 25.9% of patients phenoconverted to a CYP2D6 poor metabolizer. This retrospective chart review pilot study highlights the value of a multidisciplinary treatment approach to deliver precision healthcare by improving physician clinical decisions and potentially impacting patient outcomes. It also shows the feasibility to implement PGx testing in neurodevelopmental/neurobehavioral disorders.

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Landmarks of pharmacogenomics and some considerations for clinical practice

Cited by 3 publications

References 17 publications

Out‐of‐pocket and private pay in clinical genetic testing: A scoping review

Out‐of‐pocket and private pay in clinical genetic testing: A scoping review

The emergence, implementation, and future growth of pharmacogenomics in psychiatry: a narrative review

Multidisciplinary Consulting Team for Complicated Cases of Neurodevelopmental and Neurobehavioral Disorders: Assessing the Opportunities and Challenges of Integrating Pharmacogenomics into a Team Setting

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