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Applicability of Pharmacogenomically Guided Medication Treatment during Hospitalization of At-Risk Minority Patients
Known disparities exist in the availability of pharmacogenomic information for minority populations, amplifying uncertainty around clinical utility for these groups. We conducted a multi-site inpatient pharmacogenomic implementation program among self-identified African-Americans (AA; n = 135) with...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709436/ https://www.ncbi.nlm.nih.gov/pubmed/34945816 http://dx.doi.org/10.3390/jpm11121343 |
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author | Saulsberry, Loren Danahey, Keith Middlestadt, Merisa O’Leary, Kevin J. Nutescu, Edith A. Chen, Thomas Lee, James C. Ruhnke, Gregory W. George, David House, Larry van Wijk, Xander M. R. Yeo, Kiang-Teck J. Choksi, Anish Hartman, Seth W. Knoebel, Randall W. Friedman, Paula N. Rasmussen, Luke V. Ratain, Mark J. Perera, Minoli A. Meltzer, David O. O’Donnell, Peter H. |
author_facet | Saulsberry, Loren Danahey, Keith Middlestadt, Merisa O’Leary, Kevin J. Nutescu, Edith A. Chen, Thomas Lee, James C. Ruhnke, Gregory W. George, David House, Larry van Wijk, Xander M. R. Yeo, Kiang-Teck J. Choksi, Anish Hartman, Seth W. Knoebel, Randall W. Friedman, Paula N. Rasmussen, Luke V. Ratain, Mark J. Perera, Minoli A. Meltzer, David O. O’Donnell, Peter H. |
author_sort | Saulsberry, Loren |
collection | PubMed |
description | Known disparities exist in the availability of pharmacogenomic information for minority populations, amplifying uncertainty around clinical utility for these groups. We conducted a multi-site inpatient pharmacogenomic implementation program among self-identified African-Americans (AA; n = 135) with numerous rehospitalizations (n = 341) from 2017 to 2020 (NIH-funded ACCOuNT project/clinicaltrials.gov#NCT03225820). We evaluated the point-of-care availability of patient pharmacogenomic results to healthcare providers via an electronic clinical decision support tool. Among newly added medications during hospitalizations and at discharge, we examined the most frequently utilized medications with associated pharmacogenomic results. The population was predominantly female (61%) with a mean age of 53 years (range 19–86). On average, six medications were newly prescribed during each individual hospital admission. For 48% of all hospitalizations, clinical pharmacogenomic information was applicable to at least one newly prescribed medication. Most results indicated genomic favorability, although nearly 29% of newly prescribed medications indicated increased genomic caution (increase in toxicity risk/suboptimal response). More than one of every five medications prescribed to AA patients at hospital discharge were associated with cautionary pharmacogenomic results (most commonly pantoprazole/suboptimal antacid effect). Notably, high-risk pharmacogenomic results (genomic contraindication) were exceedingly rare. We conclude that the applicability of pharmacogenomic information during hospitalizations for vulnerable populations at-risk for experiencing health disparities is substantial and warrants continued prospective investigation. |
format | Online Article Text |
id | pubmed-8709436 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-87094362021-12-25 Applicability of Pharmacogenomically Guided Medication Treatment during Hospitalization of At-Risk Minority Patients Saulsberry, Loren Danahey, Keith Middlestadt, Merisa O’Leary, Kevin J. Nutescu, Edith A. Chen, Thomas Lee, James C. Ruhnke, Gregory W. George, David House, Larry van Wijk, Xander M. R. Yeo, Kiang-Teck J. Choksi, Anish Hartman, Seth W. Knoebel, Randall W. Friedman, Paula N. Rasmussen, Luke V. Ratain, Mark J. Perera, Minoli A. Meltzer, David O. O’Donnell, Peter H. J Pers Med Article Known disparities exist in the availability of pharmacogenomic information for minority populations, amplifying uncertainty around clinical utility for these groups. We conducted a multi-site inpatient pharmacogenomic implementation program among self-identified African-Americans (AA; n = 135) with numerous rehospitalizations (n = 341) from 2017 to 2020 (NIH-funded ACCOuNT project/clinicaltrials.gov#NCT03225820). We evaluated the point-of-care availability of patient pharmacogenomic results to healthcare providers via an electronic clinical decision support tool. Among newly added medications during hospitalizations and at discharge, we examined the most frequently utilized medications with associated pharmacogenomic results. The population was predominantly female (61%) with a mean age of 53 years (range 19–86). On average, six medications were newly prescribed during each individual hospital admission. For 48% of all hospitalizations, clinical pharmacogenomic information was applicable to at least one newly prescribed medication. Most results indicated genomic favorability, although nearly 29% of newly prescribed medications indicated increased genomic caution (increase in toxicity risk/suboptimal response). More than one of every five medications prescribed to AA patients at hospital discharge were associated with cautionary pharmacogenomic results (most commonly pantoprazole/suboptimal antacid effect). Notably, high-risk pharmacogenomic results (genomic contraindication) were exceedingly rare. We conclude that the applicability of pharmacogenomic information during hospitalizations for vulnerable populations at-risk for experiencing health disparities is substantial and warrants continued prospective investigation. MDPI 2021-12-10 /pmc/articles/PMC8709436/ /pubmed/34945816 http://dx.doi.org/10.3390/jpm11121343 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Saulsberry, Loren Danahey, Keith Middlestadt, Merisa O’Leary, Kevin J. Nutescu, Edith A. Chen, Thomas Lee, James C. Ruhnke, Gregory W. George, David House, Larry van Wijk, Xander M. R. Yeo, Kiang-Teck J. Choksi, Anish Hartman, Seth W. Knoebel, Randall W. Friedman, Paula N. Rasmussen, Luke V. Ratain, Mark J. Perera, Minoli A. Meltzer, David O. O’Donnell, Peter H. Applicability of Pharmacogenomically Guided Medication Treatment during Hospitalization of At-Risk Minority Patients |
title | Applicability of Pharmacogenomically Guided Medication Treatment during Hospitalization of At-Risk Minority Patients |
title_full | Applicability of Pharmacogenomically Guided Medication Treatment during Hospitalization of At-Risk Minority Patients |
title_fullStr | Applicability of Pharmacogenomically Guided Medication Treatment during Hospitalization of At-Risk Minority Patients |
title_full_unstemmed | Applicability of Pharmacogenomically Guided Medication Treatment during Hospitalization of At-Risk Minority Patients |
title_short | Applicability of Pharmacogenomically Guided Medication Treatment during Hospitalization of At-Risk Minority Patients |
title_sort | applicability of pharmacogenomically guided medication treatment during hospitalization of at-risk minority patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709436/ https://www.ncbi.nlm.nih.gov/pubmed/34945816 http://dx.doi.org/10.3390/jpm11121343 |
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