Impact of Updating Pharmacogenetic Results: Lessons Learned from the PREDICT Program

Pharmacogenomic (PGx) evidence for selective serotonin reuptake inhibitors (SSRIs) continues to evolve. For sites offering testing, maintaining up-to-date interpretations and implementing new clinical decision support (CDS) driven by existing results creates practical and technical challenges. Vande...

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Autores principales:	Michelle Liu, Sara L. Van Driest, Cindy L. Vnencak-Jones, Leigh Ann G. Saucier, Bartholomew P. Roland, Cheryl L. Gatto, Shari L. Just, Asli O. Weitkamp, Josh F. Peterson
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	pharmacogenomics pharmacogenetics personalized medicine precision medicine SSRIs reprocessing Medicine R
Acceso en línea:	https://doaj.org/article/59b4c678d0c74fe7be7ea8ccb90969b1
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spelling	oai:doaj.org-article:59b4c678d0c74fe7be7ea8ccb90969b12021-11-25T18:06:44ZImpact of Updating Pharmacogenetic Results: Lessons Learned from the PREDICT Program10.3390/jpm111110512075-4426https://doaj.org/article/59b4c678d0c74fe7be7ea8ccb90969b12021-10-01T00:00:00Zhttps://www.mdpi.com/2075-4426/11/11/1051https://doaj.org/toc/2075-4426Pharmacogenomic (PGx) evidence for selective serotonin reuptake inhibitors (SSRIs) continues to evolve. For sites offering testing, maintaining up-to-date interpretations and implementing new clinical decision support (CDS) driven by existing results creates practical and technical challenges. Vanderbilt University Medical Center initiated panel testing in 2010, added <i>CYP2D6</i> testing in 2017, and released CDS for SSRIs in 2020. We systematically reinterpreted historic <i>CYP2C19</i> and <i>CYP2D6</i> genotypes to update phenotypes to current nomenclature and to launch provider CDS and patient-oriented content for SSRIs. Chart review was conducted to identify and recontact providers caring for patients with current SSRI therapy and new actionable recommendations. A total of 15,619 patients’ PGx results were reprocessed. Of the non-deceased patients reprocessed, 21% (<i>n</i> = 3278) resulted in <i>CYP2C19</i><i>1/17</i> reinterpretations. Among 289 patients with an actionable recommendation and SSRI medication prescription, 31.8% (<i>n</i> = 92) did not necessitate contact of a clinician, while 43.2% (<i>n</i> = 125) resulted in clinician contacted, and for 25% (<i>n</i> = 72) no appropriate clinician was able to be identified. Maintenance of up-to-date interpretations and recommendations for PGx results over the lifetime of a patient requires continuous effort. Reprocessing is a key strategy for maintenance and expansion of PGx content to be periodically considered and implemented.Michelle LiuSara L. Van DriestCindy L. Vnencak-JonesLeigh Ann G. SaucierBartholomew P. RolandCheryl L. GattoShari L. JustAsli O. WeitkampJosh F. PetersonMDPI AGarticlepharmacogenomicspharmacogeneticspersonalized medicineprecision medicineSSRIsreprocessingMedicineRENJournal of Personalized Medicine, Vol 11, Iss 1051, p 1051 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pharmacogenomics pharmacogenetics personalized medicine precision medicine SSRIs reprocessing Medicine R
spellingShingle	pharmacogenomics pharmacogenetics personalized medicine precision medicine SSRIs reprocessing Medicine R Michelle Liu Sara L. Van Driest Cindy L. Vnencak-Jones Leigh Ann G. Saucier Bartholomew P. Roland Cheryl L. Gatto Shari L. Just Asli O. Weitkamp Josh F. Peterson Impact of Updating Pharmacogenetic Results: Lessons Learned from the PREDICT Program
description	Pharmacogenomic (PGx) evidence for selective serotonin reuptake inhibitors (SSRIs) continues to evolve. For sites offering testing, maintaining up-to-date interpretations and implementing new clinical decision support (CDS) driven by existing results creates practical and technical challenges. Vanderbilt University Medical Center initiated panel testing in 2010, added <i>CYP2D6</i> testing in 2017, and released CDS for SSRIs in 2020. We systematically reinterpreted historic <i>CYP2C19</i> and <i>CYP2D6</i> genotypes to update phenotypes to current nomenclature and to launch provider CDS and patient-oriented content for SSRIs. Chart review was conducted to identify and recontact providers caring for patients with current SSRI therapy and new actionable recommendations. A total of 15,619 patients’ PGx results were reprocessed. Of the non-deceased patients reprocessed, 21% (<i>n</i> = 3278) resulted in <i>CYP2C19</i><i>1/17</i> reinterpretations. Among 289 patients with an actionable recommendation and SSRI medication prescription, 31.8% (<i>n</i> = 92) did not necessitate contact of a clinician, while 43.2% (<i>n</i> = 125) resulted in clinician contacted, and for 25% (<i>n</i> = 72) no appropriate clinician was able to be identified. Maintenance of up-to-date interpretations and recommendations for PGx results over the lifetime of a patient requires continuous effort. Reprocessing is a key strategy for maintenance and expansion of PGx content to be periodically considered and implemented.
format	article
author	Michelle Liu Sara L. Van Driest Cindy L. Vnencak-Jones Leigh Ann G. Saucier Bartholomew P. Roland Cheryl L. Gatto Shari L. Just Asli O. Weitkamp Josh F. Peterson
author_facet	Michelle Liu Sara L. Van Driest Cindy L. Vnencak-Jones Leigh Ann G. Saucier Bartholomew P. Roland Cheryl L. Gatto Shari L. Just Asli O. Weitkamp Josh F. Peterson
author_sort	Michelle Liu
title	Impact of Updating Pharmacogenetic Results: Lessons Learned from the PREDICT Program
title_short	Impact of Updating Pharmacogenetic Results: Lessons Learned from the PREDICT Program
title_full	Impact of Updating Pharmacogenetic Results: Lessons Learned from the PREDICT Program
title_fullStr	Impact of Updating Pharmacogenetic Results: Lessons Learned from the PREDICT Program
title_full_unstemmed	Impact of Updating Pharmacogenetic Results: Lessons Learned from the PREDICT Program
title_sort	impact of updating pharmacogenetic results: lessons learned from the predict program
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/59b4c678d0c74fe7be7ea8ccb90969b1
work_keys_str_mv	AT michelleliu impactofupdatingpharmacogeneticresultslessonslearnedfromthepredictprogram AT saralvandriest impactofupdatingpharmacogeneticresultslessonslearnedfromthepredictprogram AT cindylvnencakjones impactofupdatingpharmacogeneticresultslessonslearnedfromthepredictprogram AT leighanngsaucier impactofupdatingpharmacogeneticresultslessonslearnedfromthepredictprogram AT bartholomewproland impactofupdatingpharmacogeneticresultslessonslearnedfromthepredictprogram AT cheryllgatto impactofupdatingpharmacogeneticresultslessonslearnedfromthepredictprogram AT shariljust impactofupdatingpharmacogeneticresultslessonslearnedfromthepredictprogram AT aslioweitkamp impactofupdatingpharmacogeneticresultslessonslearnedfromthepredictprogram AT joshfpeterson impactofupdatingpharmacogeneticresultslessonslearnedfromthepredictprogram
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Impact of Updating Pharmacogenetic Results: Lessons Learned from the PREDICT Program

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