Patient experiences with pharmacogenetic testing in a primary care setting

Haga, Susanne B.; Mills, Rachel; Moaddeb, Jivan; Lapointe, Nancy Allen; Cho, Alex; Ginsburg, Geoffrey S.

doi:10.2217/pgs-2016-0077

Cited by 38 publications

(70 citation statements)

References 32 publications

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“…Physicians completed surveys at two time points, and chart reviews were conducted at three time points. Findings from the patient perspective are reviewed in a separate manuscript [35]. The study was approved by the Duke University Health System's Institutional Review Board (Pro#00031122).…”

Section: Methodsmentioning

confidence: 99%

Primary care providers’ use of pharmacist support for delivery of pharmacogenetic testing

et al. 2017

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Aim. To investigate provider utilization of pharmacist support in the delivery of pharmacogenetic testing in a primary care setting. Methods. Two primary care clinics within Duke University Health System participated in the study between December 2012 and July 2013. One clinic was provided with an in-house pharmacist and the second clinic had an on-call pharmacist. Results: Providers in the in-house pharmacist arm consulted with the pharmacist for 13 of 15 cases, or about one of every four patients tested compared with one of every 7.5 patients in the on-call pharmacist arm. A total of 63 tests were ordered, 48 by providers in the pharmacist-in-house arm. Conclusion: These findings suggest that the availability of an in-house pharmacist increases the likelihood of pharmacogenetic test utilization.

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Section: Methodsmentioning

confidence: 99%

Primary care providers’ use of pharmacist support for delivery of pharmacogenetic testing

et al. 2017

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“…Provider use and attitudes : Studies in which results were delivered to prescribers enabled an examination of how frequently they interfaced with the information and their attitudes about its value. Studies in which providers initiated SLCO1B1 testing generally reported low testing uptake . Studies delivering SLCO1B1 results to providers through the EHR without provider initiation have reported providers’ EHR transactional data.…”

Section: Resultsmentioning

confidence: 99%

“…Prescribing behavior and prescriptions : Most studies have reported or are actively collecting data on the impact of SLCO1B1 results on medication prescriptions, measured from either the EHR or the provider or patient report. Some studies of pharmacogenetic panel testing have reported only composite medication changes, whereas small pilot studies have reported specific cases where SLCO1B1 results guided therapy . Large studies with SLCO1B1 CDS alerts have reported counts of medication changes attributed to pharmacogenetic results.…”

Section: Resultsmentioning

confidence: 99%

“…Medication adherence : Although prescriptions largely reflect provider behavior, medication adherence is a patient behavior. Small pilot studies have either found no impact of SLCO1B1 testing on statin adherence or did not collect data to enable before–after or between‐group comparisons . The Duke nonrandomized pilot study among patients with prior statin discontinuation found that 47% of intervention patients reported taking a statin after 4 months compared with 15% of concurrent controls after 1 year ( P < 0.001) .…”

Section: Resultsmentioning

confidence: 99%

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Impact of SLCO1B1 Pharmacogenetic Testing on Patient and Healthcare Outcomes: A Systematic Review

Vassy

Chun

Advani

et al. 2018

Clin Pharma and Therapeutics

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Demonstrated improvements in patient outcomes will facilitate the clinical implementation of pharmacogenetic testing. Using the association between solute carrier organic anion transporter family member 1B1 (SLCO1B1) and statin-associated muscle symptoms (SAMSs) as a model, we conducted a systematic review of patient outcomes after delivery of SLCO1B1 results. Using PubMed and Embase searches through December 19, 2017, we identified 37 eligible records reporting preliminary or final outcomes, including six studies delivering only SLCO1B1 results and five large healthcare system-based implementation projects of multipharmacogene panels. Two small trials have demonstrated at least short-term improvements in low-density lipoprotein cholesterol after SLCO1B1 testing among previously statin intolerant patients. Evidence from large implementation projects suggests that SLCO1B1 results may change prescribing patterns for some high-risk patients. No study has reported improvements in SAMSs or cardiovascular events or tracked the economic outcomes of SLCO1B1 testing. Ongoing studies should collect and report outcomes relevant to pharmacogenetics stakeholders.

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“…Additionally, pharmacists have the foundational education and training to interpret pharmacogenomic results given their expertise in pharmacokinetics, drug metabolism, and medication adverse effect profiles . Pharmacists may use pharmacogenomic results to tailor treatment plans for patients with depression to reduce the risk of adverse effects and increase drug tolerability, ultimately improving the patient experience …”

Section: Discussionmentioning

confidence: 99%

Perspectives of a pharmacist‐run pharmacogenomic service for depression in interdisciplinary family medicine practices

Weinstein

Carroll

Jukic

et al. 2019

J Am Coll Clin Pharm

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Objectives Pharmacists in primary care practices are uniquely positioned to use pharmacogenomic data to drive personalized medical treatment for patients with depression. To date, there are limited data exploring the implementation and utility of a pharmacist‐run pharmacogenomic service within physician office practices. This project explored pharmacist and physician perspectives on how to implement a pharmacist‐run pharmacogenomic service to optimize pharmacotherapy and aid in informed decision‐making when initiating treatment for depression in primary care practices. Methods Family medicine physicians and their associated pharmacists were invited via email to participate in semi‐structured, key informant interviews with a pharmacist investigator. Interview questions were informed using the Consolidated Framework for Implementation Research. Interviews were audio recorded and transcribed. Transcripts were independently coded by two investigators. Coding discrepancies were resolved. A thematic analysis was performed. Results Twenty‐one interviews were conducted. Six major themes emerged upon analysis: (1) Utilizing pharmacogenomics in the primary care setting may be a tool to help individualize initial medication selection for patients with depression; (2) Implementing a pharmacist‐driven pharmacogenomics service begins with a prescriber‐patient interaction and includes a subsequent team‐based approach with open lines of communication; (3) Trained pharmacists who have collaborative relationships with an outpatient physician practice should interpret pharmacogenomic results and select appropriate pharmacotherapy; (4) Appropriate patient selection, engagement, and education are critical factors to consider when designing a pharmacist‐driven pharmacogenomics service; (5) Patient monitoring and follow‐up responsibilities will be shared amongst team members and; (6) Education on Interpretation and Implementation of Pharmacogenomic Data for the Treatment of Depression is Necessary for Health Care Professionals. Conclusions Physicians and pharmacists view pharmacogenomics as a useful tool to individualize pharmacotherapy for patients with depression. Team‐based care is required for patient engagement, effective communication, and follow‐up. Pharmacists are key team members who will interpret pharmacogenomic results and provide requisite recommendations.

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Patient experiences with pharmacogenetic testing in a primary care setting

Cited by 38 publications

References 32 publications

Primary care providers’ use of pharmacist support for delivery of pharmacogenetic testing

Primary care providers’ use of pharmacist support for delivery of pharmacogenetic testing

Impact of SLCO1B1 Pharmacogenetic Testing on Patient and Healthcare Outcomes: A Systematic Review

Perspectives of a pharmacist‐run pharmacogenomic service for depression in interdisciplinary family medicine practices

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