Changing from mandatory to optional genotyping results in higher acceptance of pharmacist-guided warfarin dosing.
Ashwini ZolekarKibum KimJames C LeeJin HanJulio D DuarteWilliam L GalanterLarisa H CavallariEdith A NutescuPublished in: Pharmacogenomics (2022)
Aim: We evaluated the clinical acceptance and feasibility of a pharmacist-guided personalized consult service following its transition from a mandatory (mPGx) to optional (oPGx) CYP2C9 / VKORC1 / CYP4F2 genotyping for warfarin. Methods: A total of 1105 patients were included. Clinical acceptance and feasibility outcomes were analyzed using bivariate and multivariable analyses. Results: After transitioning to optional genotyping, genotype testing was still ordered in a large segment of the eligible population (52.1%). Physician acceptance of pharmacist-recommended doses improved from 83.9% (mPGx) to 86.6% (oPGx; OR: 1.3; 95% CI: 1.1-1.5; p = 0.01) with a shorter median genotype result turnaround time (oPGX: 23.6 h vs mPGX: 25.1 h; p < 0.01). Conclusion : Ordering of genotype testing and provider acceptance of dosing recommendations remained high after transitioning to optional genotyping.
Keyphrases
- genome wide
- high throughput
- end stage renal disease
- primary care
- atrial fibrillation
- genetic diversity
- chronic kidney disease
- venous thromboembolism
- emergency department
- healthcare
- newly diagnosed
- direct oral anticoagulants
- ejection fraction
- prognostic factors
- mental health
- peritoneal dialysis
- dna methylation
- metabolic syndrome