Opportunity for Genotype‐Guided Prescribing Among Adult Patients in 11 US Health Systems

作者：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 Blake, James J. Cimino, Brittney H. Davis, Philip E. Empey, David Kao, Daniel L. Lemkin, Nita A. Limdi, Gloria 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, IGNITE Pharmacogenetics Working Group · 发表于：Clinical Pharmacology & Therapeutics · 年份：2021 · DOI：10.1002/cpt.2161 · 被引用次数：60 · 研究领域：Pharmacogenetics and Drug Metabolism、Pharmaceutical studies and practices、Pharmaceutical Practices and Patient Outcomes

The value of utilizing a multigene pharmacogenetic panel to tailor pharmacotherapy is contingent on the prevalence of prescribed medications with an actionable pharmacogenetic association. The Clinical Pharmacogenetics Implementation Consortium (CPIC) has categorized over 35 gene-drug pairs as "level A," for which there is sufficiently strong evidence to recommend that genetic information be used to guide drug prescribing. The opportunity to use genetic information to tailor pharmacotherapy among adult patients was determined by elucidating the exposure to CPIC level A drugs among 11 Implementing Genomics In Practice Network (IGNITE)-affiliated health systems across the US. Inpatient and/or outpatient electronic-prescribing data were collected between January 1, 2011 and December 31, 2016 for patients ≥ 18 years of age who had at least one medical encounter that was eligible for drug prescribing in a calendar year. A median of ~ 7.2 million adult patients was available for assessment of drug prescribing per year. From 2011 to 2016, the annual estimated prevalence of exposure to at least one CPIC level A drug prescribed to unique patients ranged between 15,719 (95% confidence interval (CI): 15,658-15,781) in 2011 to 17,335 (CI: 17,283-17,386) in 2016 per 100,000 patients. The estimated annual exposure to at least 2 drugs was above 7,200 per 100,000 patients in most years of the study, reaching an apex of 7,660 (CI: 7,632-7,687) per 100,000 patients in 2014. An estimated 4,748 ...