Pharmacogenetic Testing in an Academic Psychiatric Clinic: A Retrospective Chart Review

Abstract

Pharmacogenomic (PGx) testing is being increasingly recognized by clinicians as an essential tool to guide medication decisions for treatment of psychiatric illnesses. Extensive implementation of PGx testing, however, varies by setting and location. In this retrospective study, we reviewed charts from 592 patients diagnosed with a psychiatric disorder at the Loyola University Medical Center, for whom PGx testing was performed. Information collected included demographics at the time of testing, psychiatric diagnosis, medical and psychiatric history and medications prior and after PGx testing. Of the 592 charts analyzed, the most common primary diagnoses were depression (52%) and anxiety (12%). Prior to PGx testing, 72% of patients were prescribed three or more medications, whereas, after testing, only 44% were prescribed three or more medications included in the test panel (p < 0.0001). The most common clinical consideration on the PGx reports was recommendation to reduce dosages (33%). After PGx testing, the proportion of patients taking incongruent medications decreased from 26% to 19% and that of patients taking congruent medications increased from 74% to 81% (p = 0.006). The results from this retrospective data analysis demonstrated a reduction in polypharmacy and an increase in recommendation-congruent medication prescribing resulting from implementation of PGx testing.

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“…Diversos estudos já ressaltaram os benefícios clínicos da aplicação de testes farmacogenéticos como guia na seleção do tratamento medicamentoso para pacientes com depressão (Bousman et al, 2019;Ielmini et al, 2022;Brown et al, 2022;Brown et al, 2021;Rosenblat et al, 2018). Esses estudos analisaram desfechos cruciais, incluindo taxas de resposta, remissão e incidência de eventos adversos.…”

Psychiatric mental health nurse practitioner student knowledge and perceptions of pharmacogenetic testing

“…Meta-analyses showed improved symptom remission when PGx was used in combination with provider expertise (Brown et al, 2021). Furthermore, the science of personalized prescribing is supported by evidence regarding the influence of several genetic variants on the pharmacokinetic actions of drugs.…”