Larisa H. Cavallari, PharmD1; Rachel A. Myers, PhD; Hrishikesh Chakraborty, DrPH
- DOI: 10.1001/jamanetworkopen.2025.58299
- Article on Jama Network
Larisa H. Cavallari, PharmD1; Rachel A. Myers, PhD; Hrishikesh Chakraborty, DrPH
Skaar TC, Myers RA, Fillingim RB, Callaghan JT, Cicali E, Eadon MT, Elwood EN, Ginsburg GS, Lynch S, Nguyen KA, Obeng AO, Park H, Pratt VM, Rosenman M, Sadeghpour A, Shuman S, Singh R, Tillman EM, Volpi S, Wiisanen K, Winterstein AG, Horowitz CR, Voora D, Orlando L, Chakraborty H, Van Driest S, Peterson JF, Cavallari LA, Johnson JA, Dexter PR
Hines LJ, Wilke RA, Myers R, Mathews CA, Liu M, Baye JF, Petry N, Cicali EJ, Duong BQ, Elwood E, Hulvershorn L, Nguyen K, Ramos M, Sadeghpour A, Wu RR, Williamson L, Wiisanen K, Voora D, Singh R, Blake KV, Murrough JW, Volpi S, Ginsburg GS, Horowitz CR, Orlando L, Chakraborty H, Dexter P, Johnson JA, Skaar TC, Cavallari LH, Van Driest SL, Peterson JF
There is growing interest in utilizing pharmacogenetic (PGx) testing to guide antidepressant use, but there is lack of clarity on how to implement testing into clinical practice. We administered two surveys at 17 sites that had implemented or were in the process of implementing PGx testing for antidepressants. Survey 1 collected data on the process and logistics of testing. Survey 2 asked sites to rank the importance of Consolidated Framework for Implementation Research (CFIR) constructs using best-worst scaling choice experiments. Of the 17 sites, 13 had implemented testing and four were in the planning stage. Thirteen offered testing in the outpatient setting, and nine in both outpatient/inpatient settings. PGx tests were mainly ordered by psychiatry (92%) and primary care (69%) providers. CYP2C19 and CYP2D6 were the most commonly tested genes. The justification for antidepressants selected for PGx guidance was based on Clinical Pharmacogenetics Implementation Consortium guidelines (94%) and US Food and Drug Administration (FDA; 75.6%) guidance. Both institutional (53%) and commercial laboratories (53%) were used for testing. Sites varied on the methods for returning results to providers and patients. Sites were consistent in ranking CFIR constructs and identified patient needs/resources, leadership engagement, intervention knowledge/beliefs, evidence strength and quality, and the identification of champions as most important for implementation. Sites deployed similar implementation strategies and measured similar outcomes. The process of implementing PGx testing to guide antidepressant therapy varied across sites, but key drivers for successful implementation were similar and may help guide other institutions interested in providing PGx-guided pharmacotherapy for antidepressant management.
Julio D. Duarte, Rachel Dalton, Amanda L. Elchynski, D. Max Smith, Emily J. Cicali, James C. Lee, Benjamin Q. Duong, Natasha J. Petry, Christina L. Aquilante, Amber L. Beitelshees, Philip E. Empey, Julie A. Johnson, Aniwaa Owusu Obeng, Amy L. Pasternak, Victoria M. Pratt, Laura B. Ramsey, Sony Tuteja, Sara L. Van Driest, Kristin Wiisanen, J. Kevin Hicks, Larisa H. Cavallari & IGNITE Network Pharmacogenetics Working Group
Genetics in Medicine volume 23, pages2335–2341 (2021)
A critical gap in the adoption of genomic medicine into medical practice is the need for the rigorous evaluation of the utility of genomic medicine interventions.
J. Kevin Hicks, Nihal El Rouby,Henry H. Ong, Jonathan S. Schildcrout, Laura B. Ramsey, Yaping Shi,Leigh Anne Tang, Christina L. Aquilante,Amber L. Beitelshees, Kathryn V. Blake, James J. Cimino,Brittney H. Davis, Philip E. Empey, David P. Kao,Daniel L. Lemkin, Nita A. Limdi, Gloria P. Lipori, Marc B. Rosenman, Todd C. Skaar, Evgenia Teal, Sony Tuteja, Laura K. Wiley, Helen Williams, Almut G. Winterstein, Sara L. Van Driest, Larisa H. Cavallari, Josh F. Peterson, on behalf of the IGNITE Pharmacogenetics Working Group