Nadkarni, G. N., Fei, K., Ramos, M. A., Hauser, D., Bagiella, E., Ellis, S. B., Sanderson, S., Scott, S. A., Sabin, T., Madden, E., Cooper, R., Pollak, M., Calman, N., Bottinger, E. P., & Horowitz, C. R.
CYP2C19 Genotype-Guided Antiplatelet Therapy After Percutaneous Coronary Intervention in Diverse Clinical Settings
PMID: 35156424 DOI: 10.1161/JAHA.121.024159
Multisite evaluation of institutional processes and implementation determinants for pharmacogenetic testing to guide antidepressant therapy
Abstract
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.
Multisite investigation of strategies for the clinical implementation of pre-emptive pharmacogenetic testing
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)
Multi-Institutional Implementation of Clinical Decision Support for APOL1, NAT2, and YEATS4 Genotyping in Antihypertensive Management.
Schneider TM, Eadon MT, Cooper-DeHoff RM, Cavanaugh KL, Nguyen KA, Arwood MJ, Tillman EM, Pratt VM, Dexter PR, McCoy AB, Orlando LA, Scott SA, Nadkarni GN, Horowitz CR, Kannry JL.
J Pers Med. 2021 May 27;11(6):480. doi: 10.3390/jpm11060480.
PMID: 34071920
Establishing the value of genomics in medicine: the IGNITE Pragmatic Trials Network
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.
Opportunity for Genotype-Guided Prescribing Among Adult Patients in 11 US Health Systems
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
Impact of the CYP2C19*17 Allele on Outcomes in Patients Receiving Genotype-Guided Antiplatelet Therapy After Percutaneous Coronary Intervention
Physician-Reported Benefits and Barriers to Clinical Implementation of Genomic Medicine: A Multi-Site IGNITE-Network Survey
Journal of Personalized Medicine – To understand potential barriers and provider attitudes, we surveyed 285 physicians from five Implementing GeNomics In pracTicE (IGNITE) sites about their perceptions as to the clinical utility of genetic data as well as their preparedness to integrate it into practice.