Changing from mandatory to optional genotyping results in higher acceptance of pharmacist-guided warfarin dosing

被引：1

作者：

Zolekar, Ashwini ^{[1
]}

Kim, Kibum ^{[1
]}

Lee, James C. ^{[2
]}

Han, Jin ^{[2
,3
]}

Duarte, Julio D. ^{[4
,5
]}

Galanter, William L. ^{[1
,2
,6
]}

Cavallari, Larisa H. ^{[4
,5
]}

Nutescu, Edith A. ^{[2
,3
]}

机构：

[1] Univ Illinois, Coll Pharm, Dept Pharm Syst Outcomes & Policy, Chicago, IL 60612 USA

[2] Univ Illinois, Coll Pharm, Dept Pharm Practice, Chicago, IL 60612 USA

[3] Univ Illinois, Ctr Pharmacoepidemiol & Pharmacoecon Res, Chicago, IL 60612 USA

[4] Univ Florida, Coll Pharm, Dept Pharmacotherapy & Translat Res, Gainesville, FL 32610 USA

[5] Univ Florida, Coll Pharm, Ctr Pharmacogen & Precis Med, Gainesville, FL 32610 USA

[6] Univ Illinois, Coll Med, Dept Med, Chicago, IL 60612 USA

来源：

PHARMACOGENOMICS | 2021年 / 23卷 / 02期

关键词：

anticoagulation PGx; cardiovascular PGx; clinical pharmacogenomics; health records; optional genotyping; pharmacist-guided pharmacogenomics consult service; warfarin; warfarin genotyping; RANDOMIZED-TRIAL; CYP2C9; GENOTYPE; PILOT TRIAL; ANTICOAGULATION; MANAGEMENT; THERAPY; EVENTS; IMPACT; PREDICTION; ALGORITHM;

D O I：

10.2217/pgs-2021-0109

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Aim: We evaluated the clinical acceptance and feasibility of a pharmacist-guided personalized consult service following its transition from a mandatory (mPGx) to optional (oPGx) CYP2C9/VKORC1/CYP4F2 genotyping for warfarin. Methods: A total of 1105 patients were included. Clinical acceptance and feasibility outcomes were analyzed using bivariate and multivariable analyses. Results: After transitioning to optional genotyping, genotype testing was still ordered in a large segment of the eligible population (52.1%). Physician acceptance of pharmacist-recommended doses improved from 83.9% (mPGx) to 86.6% (oPGx; OR: 1.3; 95% CI: 1.1-1.5; p = 0.01) with a shorter median genotype result turnaround time (oPGX: 23.6 hr vs mPGX: 25.1 hr ; p < 0.01). Conclusion: Ordering of genotype testing and provider acceptance of dosing recommendations remained high after transitioning to optional genotyping.

引用

页码：85 / 95

页数：11

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