Pharmacogenomics (PGx) is a field that aims to improve clinical outcomes and reduce healthcare costs by using genetic information to personalize drug selection and dosing. Despite the promise of PGx, many patients still receive ineffective or toxic medications. Adverse drug reactions, some of which are fatal, are also a significant concern. However, recent studies have shown that PGx testing can reduce adverse events by 30%.
Quest Diagnostics, a national clinical laboratory, offers a comprehensive PGx test panel that covers multiple indications, including mental health, pain management, oncology, neurology, and cardiology. While Quest doesn't provide medication guidance directly, the test results can be integrated with clinical decision support systems and electronic health records to assist clinicians in making optimal treatment decisions.
In mental health therapy, PGx has shown significant potential in improving clinical outcomes and cost savings. Currently, patients often go through a trial-and-error process to find the right medication, leading to low adherence, delayed response to treatment, and increased healthcare costs. PGx testing provides clinicians with information on an individual's metabolism genes and how their body responds to medications, allowing for more precise treatment plans. Studies have demonstrated improved medication efficacy, reduced adverse events, and cost savings with PGx-guided medication management for depression.
PGx is also gaining traction in polypharmacy, where patients take multiple medications. PGx testing can help decrease the number of medications, replace ineffective drugs, and reduce the risk of dangerous drug interactions. One study showed a 30% reduction in adverse events with PGx testing. Implementing PGx in medication management programs for polypharmacy patients has resulted in substantial cost savings.
Pharmacists play a crucial role in reviewing PGx results, particularly for polypharmacy patients. They can assess drug-drug and drug-gene interactions to provide guidance on doses and medications. Pharmacists in health-system and community settings are becoming increasingly involved in utilizing PGx information.
As PGx testing becomes more accessible, patients are likely to advocate for their own healthcare by requesting testing or asking clinicians to consider their PGx results. Providers may start incorporating PGx testing into their practice and electronic health records may include alerts to remind clinicians to order PGx testing. PGx testing can also supplement telehealth services and help address access gaps in mental health care.
One of the challenges to the widespread adoption of PGx testing is the need for education among healthcare professionals. Many providers are unaware of PGx or do not see its value. Provider attitudes and behaviors need to change, and clinical guidelines should be updated to include PGx testing recommendations. Reimbursement is another significant challenge, with payers requiring more evidence of clinical and economic outcomes before providing coverage. Engaging employers to offer PGx testing as a benefit to employees could help overcome reimbursement constraints.
Overall, the future of PGx testing looks promising, particularly in mental health and polypharmacy. Advances in technology, continued education, and collaboration across the clinical community will contribute to realizing the full potential of genetics in improving medication use and health outcomes.
Full article from Pharmacy Times here.