Providing patients with pharmacogenetic test results affects adherence to statin therapy: results of the Additional KIF6 Risk Offers Better Adherence to Statins (AKROBATS) trial

被引:32
作者
Charland, S. L. [1 ,2 ]
Agatep, B. C. [1 ,3 ]
Herrera, V. [1 ]
Schrader, B. [1 ,4 ]
Frueh, F. W. [1 ]
Ryvkin, M. [1 ,5 ]
Shabbeer, J. [6 ]
Devlin, J. J. [7 ]
Superko, H. R. [7 ]
Stanek, E. J. [1 ]
机构
[1] Medco Res Inst LLC, Bethesda, MD USA
[2] Univ Colorado, Skaggs Sch Pharm & Pharmaceut Sci, Aurora, CO 80482 USA
[3] Avalere Hlth LLC, Washington, DC USA
[4] Univ Arizona, Coll Pharm, Tucson, AZ 85721 USA
[5] Express Scripts, Franklin Lakes, NJ USA
[6] Ariosa Diagnost, San Jose, CA USA
[7] Celera Corp, Alameda, CA USA
关键词
KIF6; medication adherence; pharmacogenetics; statin therapy; GENOMIC MEDICINE GENOMICS; KINESIN-LIKE PROTEIN-6; MEDICATION ADHERENCE; TRP719ARG POLYMORPHISM; MYOCARDIAL-INFARCTION; ASSOCIATION; DISEASE; IMPACTS; PROGRAM; GENE;
D O I
10.1038/tpj.2013.27
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Despite the clinical benefit of statin therapy and the numerous strategies used to improve adherence, no strategy has used direct communication of genetic test results to the patient as an adherence and persistence motivator. We investigated in a real-world setting the effect of a process of providing KIF6 test results and risk information directly to 647 tested patients on 6-month statin adherence (proportion of days covered (PDC) and persistence compared with concurrent non-tested matched controls. Adjusted 6-month statin PDC was significantly greater in tested patients: 0.77 (95% confidence interval (Cl) 0.72-0.82) vs controls 0.68 (95% CI 0.63-0.73); P<0.0001. Significantly more tested patients were adherent (PDC >= 0.80) (63.4% (59.6-67.1%) vs 45.0% (41.1-48.8%), P<0.0001) and persisted on therapy (69.1% (65.4-72.5%) vs 53.3% (49.4-57.1%), P<0.0001). Similar results were observed in a secondary comparison with 779 unmatched patients who declined testing. The Additional KIF6 Risk Offers Better Adherence to Statins trial provides the first evidence that pharmacogenetic testing may modify patient adherence.
引用
收藏
页码:272 / 280
页数:9
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