Utilization of Drugs with Pharmacogenetic Dosing Recommendations in Switzerland: A Descriptive Study Using the Helsana Database

Wittwer, Nina L; Meier, Christoph; Huber, Carola A; Schwabedissen, Henriette E. Meyer zu; Allemann, Samuel; Schneider, Cornelia

doi:10.2147/pgpm.s382214

Cited by 3 publications

(2 citation statements)

References 35 publications

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“…When asking patients about the list of concerned substances, more than half of them said that they held the list ready, and three patients reckoned they had already used it. As ibuprofen is the most frequently used Swiss drug known to be affected by PGx [ 27 ], we wanted to know how patients would proceed when they were confronted with a yellow indication for such a common drug on their list of concerned substances. A majority of the patients would use the list of concerned substances to decide for or against a purchase of ibuprofen.…”

Section: Discussionmentioning

confidence: 99%

Pharmacogenetic testing and counselling in the community pharmacy: mixed-methods study of a new pharmacist-led service

et al. 2023

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Background Pharmacogenetic (PGx) testing and counselling (short: PGx service) in the community pharmacy is not routinely practiced. We propose a comprehensive pharmacist-led service where PGx information is integrated into medication reviews. Aim To evaluate the pharmacist-led service comprising PGx testing and counselling (PGx service) from the perspective of patients. Method For this mixed-methods study, we conducted two follow-up interviews F1 and F2 with patients recruited for the PGx service in a community pharmacy after 1st of January 2020. The semi-structured interviews were held by phone call and covered understanding of PGx, the implementation of recommendations, handling of PGx documents (list of concerned substances and PGx recommendation), gain in medication knowledge, and willingness to pay for the PGx service. Results We interviewed 25 patients in F1 and 42 patients in F2. Patients were generally able to understand and use results of the PGx service. At least one PGx recommendation was implemented for 69% of the patients. Handling of PGx documents ranged from patients having forgotten about the PGx results to patients consulting the list for every medication-related decision; the latter often expecting negative effects. Finally, 62% of the patients were willing to pay for the PGx service. Conclusion For future PGx testing and counselling, HCPs should consider the patients’ health literacy in a standardized way and use adequate communication skills to enhance the patient's understanding in PGx and to attenuate potential negative expectations.

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Section: Discussionmentioning

confidence: 99%

Pharmacogenetic testing and counselling in the community pharmacy: mixed-methods study of a new pharmacist-led service

et al. 2023

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“…22 At the same time, exposure to drugs affected by PGx is extremely common, reaching over 95% of the population exposed to at least one relevant drug. 23,24 The high concordance rate of suspicions and confirmations in the study can also be considered as a quality control of the study setting and the collaboration with the referring physicians. In other words, the involved physicians and pharmacists seem to be well equipped to identify patients with a potential DGI, which could benefit from PGx testing.…”

Section: Identified Interactionsmentioning

confidence: 99%

Genotyping of Patients with Adverse Drug Reaction or Therapy Failure: Database Analysis of a Pharmacogenetics Case Series Study

Bollinger¹,

Stäuble²,

Jeiziner³

et al. 2023

PGPM

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Pharmacogenetics (PGx) is an emerging aspect of personalized medicine with the potential to increase efficacy and safety of pharmacotherapy. However, PGx testing is still not routinely integrated into clinical practice. We conducted an observational case series study where PGx information from a commercially available panel test covering 30 genes was integrated into medication reviews. The aim of the study was to identify the drugs that are most frequently object of drug-gene-interactions (DGI) in the study population. Patients and Methods:In out-patient and in-patient settings, we recruited 142 patients experiencing adverse drug reaction (ADR) and/or therapy failure (TF). Collected anonymized data from the individual patient was harmonized and transferred to a structured database. Results:The majority of the patients had a main diagnosis of a mental or behavioral disorder (ICD-10: F, 61%), of musculoskeletal system and connective tissue diseases (ICD-10: M, 21%), and of the circulatory system (ICD-10: I, 11%). The number of prescribed medicines reached a median of 7 per person, resulting in a majority of patients with polypharmacy (≥5 prescribed medicines, 65%). In total, 559 suspected DGI were identified in 142 patients. After genetic testing, an association with at least one genetic variation was confirmed for 324 suspected DGI (58%) caused by 64 different drugs and 21 different genes in 141 patients. After 6 months, PGxbased medication adjustments were recorded for 62% of the study population, whereby differences were identified in subgroups. Conclusion:The data analysis from this study provides valuable insights for the main focus of further research in the context of PGx. The results indicate that most of the selected patients in our sample represent suitable target groups for PGx panel testing in clinical practice, notably those taking drugs for mental or behavioral disorder, circulatory diseases, immunological diseases, pain-related diseases, and patients experiencing polypharmacy.

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Prevalence of actionable pharmacogenetic variants and high‐risk drug prescriptions: A Swiss hospital‐based cohort study

Hodel,

De Min,

Thorball

et al. 2024

Clinical Translational Sci

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Drug type and dosing recommendation have been designed and optimized based on average response in the general population. Yet, there is significant inter‐individual variability in drug response, which results in treatment inefficacy or adverse drug reactions in a subset of patients. This is partly due to genetic factors that typically affect drug metabolism or clearance. To verify the relevance and applicability of international pharmacogenetic guidelines in the Swiss population, we genotyped 1533 patients from a hospital‐based biobank who received at least 30 different drugs, as documented in their electronic health record. We then assessed the prevalence of clinically actionable variants in 13 high‐risk pharmacogenes. We compared the allele frequencies obtained in the hospital‐based cohort with those of a Swiss population‐based cohort of 4791 individuals. The prevalence of clinically actionable variants was comparable between the two cohorts, with most study participants (97.3%) carrying at least one actionable pharmacogenetic variant. We then assessed the frequency of high‐risk prescriptions due to actionable gene–drug interactions and observed that 31% of patients in the hospital‐based cohort were prescribed at least one drug for which they carried a high‐risk variant, and for which international guidelines recommend a change of drug or dosage. Our analysis confirms the high prevalence of actionable pharmacogenetic variants in the Swiss population. It also shows that a substantial minority of patients are exposed to drugs for which they carry potentially problematic variants. Implementing a genetically informed approach to drug prescribing could have a positive impact on the quality of healthcare delivery.

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Utilization of Drugs with Pharmacogenetic Dosing Recommendations in Switzerland: A Descriptive Study Using the Helsana Database

Cited by 3 publications

References 35 publications

Pharmacogenetic testing and counselling in the community pharmacy: mixed-methods study of a new pharmacist-led service

Pharmacogenetic testing and counselling in the community pharmacy: mixed-methods study of a new pharmacist-led service

Genotyping of Patients with Adverse Drug Reaction or Therapy Failure: Database Analysis of a Pharmacogenetics Case Series Study

Prevalence of actionable pharmacogenetic variants and high‐risk drug prescriptions: A Swiss hospital‐based cohort study

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