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Applicability of Pharmacogenomically Guided Medication Treatment during Hospitalization of At-Risk Minority Patients

Authors :
Loren Saulsberry
Keith Danahey
Merisa Middlestadt
Kevin J. O’Leary
Edith A. Nutescu
Thomas Chen
James C. Lee
Gregory W. Ruhnke
David George
Larry House
Xander M. R. van Wijk
Kiang-Teck J. Yeo
Anish Choksi
Seth W. Hartman
Randall W. Knoebel
Paula N. Friedman
Luke V. Rasmussen
Mark J. Ratain
Minoli A. Perera
David O. Meltzer
Peter H. O’Donnell
Source :
Journal of Personalized Medicine, Journal of Personalized Medicine, Vol 11, Iss 1343, p 1343 (2021), Journal of Personalized Medicine; Volume 11; Issue 12; Pages: 1343
Publication Year :
2021
Publisher :
MDPI AG, 2021.

Abstract

Known disparities exist in the availability of pharmacogenomic information for minority populations, amplifying uncertainty around clinical utility for these groups. We conducted a multi-site inpatient pharmacogenomic implementation program among self-identified African-Americans (AA; n = 135) with numerous rehospitalizations (n = 341) from 2017 to 2020 (NIH-funded ACCOuNT project/clinicaltrials.gov#NCT03225820). We evaluated the point-of-care availability of patient pharmacogenomic results to healthcare providers via an electronic clinical decision support tool. Among newly added medications during hospitalizations and at discharge, we examined the most frequently utilized medications with associated pharmacogenomic results. The population was predominantly female (61%) with a mean age of 53 years (range 19–86). On average, six medications were newly prescribed during each individual hospital admission. For 48% of all hospitalizations, clinical pharmacogenomic information was applicable to at least one newly prescribed medication. Most results indicated genomic favorability, although nearly 29% of newly prescribed medications indicated increased genomic caution (increase in toxicity risk/suboptimal response). More than one of every five medications prescribed to AA patients at hospital discharge were associated with cautionary pharmacogenomic results (most commonly pantoprazole/suboptimal antacid effect). Notably, high-risk pharmacogenomic results (genomic contraindication) were exceedingly rare. We conclude that the applicability of pharmacogenomic information during hospitalizations for vulnerable populations at-risk for experiencing health disparities is substantial and warrants continued prospective investigation.

Details

ISSN :
20754426
Volume :
11
Database :
OpenAIRE
Journal :
Journal of Personalized Medicine
Accession number :
edsair.doi.dedup.....da8f4dd04e259f1cb6d454dd0bf0a589
Full Text :
https://doi.org/10.3390/jpm11121343