PGY2 oncology pharmacy resident M Health Fairview Maple Grove, Minnesota, United States
Poster Abstract: Background/Rational
Pharmacogenomics (PGx) is an emerging but largely underutilized tool for customizing drug therapy to a patient based on their genetic profile. This approach can improve efficacy and prevent toxicities by adjusting the dose prior to starting therapy. One often cited barrier to implementation is lack of utility compared with the cost of genomics testing. We believe that patients in the allogeneic hematopoietic cell transplant (allo-HCT) population are regularly prescribed enough medications with actionable gene-drug interactions to justify the cost of testing.
The University of North Carolina conducted a study to estimate the potential impact of preemptive multigene PGx testing in patients undergoing percutaneous coronary interventions or allo-HCTs. They found that 90.1% of allo-HCT patients were prescribed at least one medication with a guideline recommended actionable drug-gene interaction in addition to tacrolimus. It was estimated that about 41 out of every 100 patients would have an actionable PGx intervention.
Objectives
Design a workflow for pharmacists to document, provide counseling, and make actionable clinical recommendations in response to PGx panel results.
Develop education materials for pharmacists to feel comfortable and confident interpreting panel results.
Methods
Our health system is implementing an internal multigene PGx panel that should simplify the logistics of testing and receiving results. We will be using Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines to develop educational material for our pharmacists on actionable recommendations for regularly used medications in our allo-HCT protocols such as ondansetron, pantoprazole, and voriconazole. A template will be created for documentation of PGx results in the patient’s chart to allow for future consideration when ordering medications with actionable gene-drug interactions.
Results
Pending completion of project
References (must also be included in final poster): Cecchin, E., & Stocco, G. (2020). Pharmacogenomics and Personalized Medicine. Genes, 11(6), 679. https://doi.org/10.3390/genes11060679
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Moriyama, B., Obeng, A. O., Barbarino, J., Penzak, S. R., Henning, S. A., Scott, S. A., Agúndez, J., Wingard, J. R., McLeod, H. L., Klein, T. E., Cross, S. J., Caudle, K. E., & Walsh, T. J. (2017). Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for CYP2C19 and Voriconazole Therapy. Clinical pharmacology and therapeutics, 102(1), 45–51. https://doi.org/10.1002/cpt.583
