United States Emergency Department Use of Medications with Pharmacogenetic Recommendations

Introduction: Emergency departments (ED) use many medications with a range of therapeutic efficacy and potential significant side effects, and many medications have dosage adjustment recommendations based on the patient’s specific genotype. How frequently medications with such pharmaco-genetic recom...

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Autores principales:	Alexander T. Limkakeng Jr, Pratik Manandhar, Alaatin Erkanli, Stephanie A. Eucker, Adam Root, Deepak Voora
Formato:	article
Lenguaje:	EN
Publicado:	eScholarship Publishing, University of California 2021
Materias:	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/8b9ecebb93ef46e1b446e8581b791de3
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spelling	oai:doaj.org-article:8b9ecebb93ef46e1b446e8581b791de32021-11-17T15:19:27ZUnited States Emergency Department Use of Medications with Pharmacogenetic Recommendations1936-901810.5811/westjem.2021.5.51248https://doaj.org/article/8b9ecebb93ef46e1b446e8581b791de32021-09-01T00:00:00Zhttps://escholarship.org/uc/item/4wx1n4gfhttps://doaj.org/toc/1936-9018Introduction: Emergency departments (ED) use many medications with a range of therapeutic efficacy and potential significant side effects, and many medications have dosage adjustment recommendations based on the patient’s specific genotype. How frequently medications with such pharmaco-genetic recommendations are used in United States (US) EDs has not been studied. Methods: We conducted a cross-sectional analysis of the 2010–2015 National Hospital Ambulatory Medical Care Survey (NHAMCS). We reported the proportion of ED visits in which at least one medication with Clinical Pharmacogenetics Implementation Consortium (CPIC) recommendation of Level A or B evidence was ordered. Secondary comparisons included distributions and 95% confidence intervals of age, gender, race/ethnicity, ED disposition, geographical region, immediacy, and insurance status between all ED visits and those involving a CPIC medication. Results: From 165,155 entries representing 805,726,000 US ED visits in the 2010–2015 NHAMCS, 148,243,000 ED visits (18.4%) led to orders of CPIC medications. The most common CPIC medication was tramadol (6.3%). Visits involving CPIC medications had higher proportions of patients who were female, had private insurance and self-pay, and were discharged from the ED. They also involved lower proportions of patients with Medicare and Medicaid. Conclusion: Almost one fifth of US ED visits involve a medication with a pharmacogenetic recommendation that may impact the efficacy and toxicity for individual patients. While direct application of genotyping is still in development, it is important for emergency care providers to understand and support this technology given its potential to improve individualized, patient-centered care.Alexander T. Limkakeng JrPratik ManandharAlaatin ErkanliStephanie A. EuckerAdam RootDeepak VooraeScholarship Publishing, University of CaliforniaarticleMedicineRMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENWestern Journal of Emergency Medicine, Vol 22, Iss 6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Alexander T. Limkakeng Jr Pratik Manandhar Alaatin Erkanli Stephanie A. Eucker Adam Root Deepak Voora United States Emergency Department Use of Medications with Pharmacogenetic Recommendations
description	Introduction: Emergency departments (ED) use many medications with a range of therapeutic efficacy and potential significant side effects, and many medications have dosage adjustment recommendations based on the patient’s specific genotype. How frequently medications with such pharmaco-genetic recommendations are used in United States (US) EDs has not been studied. Methods: We conducted a cross-sectional analysis of the 2010–2015 National Hospital Ambulatory Medical Care Survey (NHAMCS). We reported the proportion of ED visits in which at least one medication with Clinical Pharmacogenetics Implementation Consortium (CPIC) recommendation of Level A or B evidence was ordered. Secondary comparisons included distributions and 95% confidence intervals of age, gender, race/ethnicity, ED disposition, geographical region, immediacy, and insurance status between all ED visits and those involving a CPIC medication. Results: From 165,155 entries representing 805,726,000 US ED visits in the 2010–2015 NHAMCS, 148,243,000 ED visits (18.4%) led to orders of CPIC medications. The most common CPIC medication was tramadol (6.3%). Visits involving CPIC medications had higher proportions of patients who were female, had private insurance and self-pay, and were discharged from the ED. They also involved lower proportions of patients with Medicare and Medicaid. Conclusion: Almost one fifth of US ED visits involve a medication with a pharmacogenetic recommendation that may impact the efficacy and toxicity for individual patients. While direct application of genotyping is still in development, it is important for emergency care providers to understand and support this technology given its potential to improve individualized, patient-centered care.
format	article
author	Alexander T. Limkakeng Jr Pratik Manandhar Alaatin Erkanli Stephanie A. Eucker Adam Root Deepak Voora
author_facet	Alexander T. Limkakeng Jr Pratik Manandhar Alaatin Erkanli Stephanie A. Eucker Adam Root Deepak Voora
author_sort	Alexander T. Limkakeng Jr
title	United States Emergency Department Use of Medications with Pharmacogenetic Recommendations
title_short	United States Emergency Department Use of Medications with Pharmacogenetic Recommendations
title_full	United States Emergency Department Use of Medications with Pharmacogenetic Recommendations
title_fullStr	United States Emergency Department Use of Medications with Pharmacogenetic Recommendations
title_full_unstemmed	United States Emergency Department Use of Medications with Pharmacogenetic Recommendations
title_sort	united states emergency department use of medications with pharmacogenetic recommendations
publisher	eScholarship Publishing, University of California
publishDate	2021
url	https://doaj.org/article/8b9ecebb93ef46e1b446e8581b791de3
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United States Emergency Department Use of Medications with Pharmacogenetic Recommendations

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