Medication Exposure Patterns in Primary Care Patients Prescribed Pharmacogenetically Actionable Opioids

Area of Science:

• Pharmacogenomics
• Health Services Research
• Qualitative Research Methods

Background:

• Current medication exposure assessments lack depth and context.
• Understanding patient medication patterns is crucial for effective pharmacotherapy.
• Opioid use, particularly codeine and tramadol, presents complex exposure challenges.

Purpose of the Study:

• To develop a patient subgroup typology based on medication exposure patterns.
• To identify distinct groups of patients with shared pharmacogenetic opioid exposure characteristics.
• To create a nuanced framework for assessing complex medication exposure.

Main Methods:

• A person-oriented qualitative approach was used.
• An exemplar sample of 30 patients prescribed codeine or tramadol was analyzed.
• Data from large healthcare repositories were utilized to examine medication exposure.

Main Results:

• Eight patient subgroups with common medication exposure patterns were identified.
• Five opioid prescription patterns were observed: singular, episodic, switching, sustained, and multiplex.
• Three primary foci of medical care (pain, comorbidities, both) were associated with these patterns.

Conclusions:

• Medication exposure patterns are dynamic, multidimensional, and complex.
• The developed typology offers an innovative method for assessing medication exposure.
• This framework can improve understanding of patient responses to pharmacogenetically actionable opioids.