Multisite investigation of strategies for the clinical implementation of pre-emptive pharmacogenetic testing

被引：44

作者：

Duarte, Julio D. ^{[1
,2
]}

Dalton, Rachel ^{[1
,2
]}

Elchynski, Amanda L. ^{[1
,2
]}

Smith, D. Max ^{[3
,4
]}

Cicali, Emily J. ^{[1
,2
]}

Lee, James C. ^{[5
]}

Duong, Benjamin Q. ^{[6
]}

Petry, Natasha J. ^{[7
,8
]}

Aquilante, Christina L. ^{[9
,10
,11
]}

Beitelshees, Amber L. ^{[12
]}

Empey, Philip E. ^{[13
]}

Johnson, Julie A. ^{[1
,2
]}

Obeng, Aniwaa Owusu ^{[14
,15
]}

Pasternak, Amy L. ^{[16
]}

Pratt, Victoria M. ^{[17
]}

Ramsey, Laura B. ^{[18
,19
,20
]}

Tuteja, Sony ^{[21
]}

Van Driest, Sara L. ^{[22
,23
]}

Wiisanen, Kristin ^{[1
,2
]}

Hicks, J. Kevin ^{[24
]}

Cavallari, Larisa H. ^{[1
,2
]}

机构：

[1] Univ Florida, Coll Pharm, Dept Pharmacotherapy & Translat Res, Gainesville, FL 32611 USA

[2] Univ Florida, Coll Pharm, Ctr Pharmacogen & Precis Med, Gainesville, FL 32611 USA

[3] MedStar Hlth, Columbia, MD USA

[4] Georgetown Univ, Med Ctr, Washington, DC 20007 USA

[5] Univ Illinois, Dept Pharm Practice, Chicago, IL USA

[6] Nemours Childrens Hlth, Precis Med, Wilmington, DE USA

[7] Sanford Hlth Imagenet, Sioux Falls, SD USA

[8] North Dakota State Univ, Dept Pharm Practice, Fargo, ND USA

[9] Univ Colorado, Colorado Ctr Personalized Med, Aurora, CO USA

[10] Univ Colorado, Dept Pharmaceut Sci, Sch Med, Aurora, CO USA

[11] Univ Colorado, Sch Pharm, Aurora, CO USA

[12] Univ Maryland, Sch Med, Dept Med, Baltimore, MD 21201 USA

[13] Univ Pittsburgh, Sch Pharm, Dept Pharm & Therapeut, Pittsburgh, PA 15261 USA

[14] Icahn Sch Med Mt Sinai, Mt Sinai Hosp, Charles Bronfman Inst Personalized Med, Dept Med, New York, NY 10029 USA

[15] Icahn Sch Med Mt Sinai, Mt Sinai Hosp, Dept Genet & Genom Sci, Pharm Dept, New York, NY 10029 USA

[16] Univ Michigan, Coll Pharm, Dept Clin Pharm, 428 Church St, Ann Arbor, MI 48109 USA

[17] Indiana Univ Sch Med, Dept Med & Mol Genet, Indianapolis, IN 46202 USA

[18] Univ Cincinnati, Coll Med, Dept Pediat, Cincinnati, OH USA

[19] Cincinnati Childrens Hosp Med Ctr, Div Res Patient Serv, Cincinnati, OH 45229 USA

[20] Cincinnati Childrens Hosp Med Ctr, Div Clin Pharmacol, Cincinnati, OH 45229 USA

[21] Univ Penn, Dept Med, Perelman Sch Med, Philadelphia, PA 19104 USA

[22] Vanderbilt Univ, Med Ctr, Dept Pediat, Nashville, TN 37232 USA

[23] Vanderbilt Univ, Med Ctr, Dept Med, Nashville, TN USA

[24] H Lee Moffitt Canc Ctr & Res Inst, Dept Individualized Canc Management, Tampa, FL USA

来源：

GENETICS IN MEDICINE | 2021年 / 23卷 / 12期

基金：

美国国家卫生研究院;

关键词：

CONSORTIUM; DRUG;

D O I：

10.1038/s41436-021-01269-9

中图分类号：

Q3 [遗传学];

学科分类号：

071007 ; 090102 ;

摘要：

Purpose The increased availability of clinical pharmacogenetic (PGx) guidelines and decreasing costs for genetic testing have slowly led to increased utilization of PGx testing in clinical practice. Pre-emptive PGx testing, where testing is performed in advance of drug prescribing, is one means to ensure results are available at the time of prescribing decisions. However, the most efficient and effective methods to clinically implement this strategy remain unclear. Methods In this report, we compare and contrast implementation strategies for pre-emptive PGx testing by 15 early-adopter institutions. We surveyed these groups, collecting data on testing approaches, team composition, and workflow dynamics, in addition to estimated third-party reimbursement rates. Results We found that while pre-emptive PGx testing models varied across sites, institutions shared several commonalities, including methods to identify patients eligible for testing, involvement of a precision medicine clinical team in program leadership, and the implementation of pharmacogenes with Clinical Pharmacogenetics Implementation Consortium guidelines available. Finally, while reimbursement rate data were difficult to obtain, the data available suggested that reimbursement rates for pre-emptive PGx testing remain low. Conclusion These findings should inform the establishment of future implementation efforts at institutions considering a pre-emptive PGx testing program.

引用

页码：2335 / 2341

页数：7

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