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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...

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Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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.
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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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