Early adoption of pharmacogenetic testing for veterans prescribed psychotropic medications

Pharmacogenomics. 2019 Jul;20(11):781-789. doi: 10.2217/pgs-2019-0065. Epub 2019 Aug 8.

Abstract

Aim: Describe the characteristics of providers ordering, patients receiving, and clinical impact of a psychotropic pharmacogenetic test on veteran care. Patients & methods: Observational cohort study linking veterans' laboratory results to electronic health record data. Changes in psychotropic medication prescribing were measured as a function of test results. Results: A total of 38 providers tested 181 veterans between 10/6/2014 and 2/1/2018. Prescriptions for medications with severe gene-drug interactions decreased; however, 11 such medications were used after testing. For 43 patients, documentation of the results was missing. Conclusion: Most prescribing decisions were congruent with test results, but in a nontrivial number of cases, prescribers appeared not to act on the results. Poor result documentation impeded the potential of results to inform clinical care.

Trial registration: ClinicalTrials.gov NCT03170362.

Keywords: pharmacogenetic testing; psychotropic medications; veterans.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Drug Interactions
  • Drug Prescriptions
  • Electronic Health Records
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pharmacogenetics*
  • Pharmacogenomic Testing*
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / genetics
  • Psychotropic Drugs / adverse effects
  • Psychotropic Drugs / therapeutic use*
  • Veterans

Substances

  • Psychotropic Drugs

Associated data

  • ClinicalTrials.gov/NCT03170362