Care Team Attributes Predict Likelihood of Utilizing Pharmacogenomic Information During Inpatient Prescribing

Area of Science:

• Pharmacogenomics
• Clinical Decision Support
• Personalized Medicine

Background:

• Medication prescribing can lead to unintended side effects, complicating patient care.
• Pharmacogenomics (PGx) offers personalized drug-related outcomes based on genotype but faces adoption challenges.
• Understanding factors influencing PGx utilization is crucial for its wider implementation.

Purpose of the Study:

• To identify patient and care team attributes that predict and promote the utilization of pharmacogenomics (PGx) data in an inpatient setting.
• To analyze the impact of various factors on the adoption of PGx clinical decision support (CDS).

Main Methods:

• Prospective trial (ACCOuNT study) involving genotyping and preemptive PGx result delivery for African American inpatients.
• PGx data was integrated into an informatics portal, with utilization determined by provider discretion.
• Statistical analysis, including logistic regression, was used to identify predictors of PGx use.

Main Results:

• Prior use of PGx information in a previous admission significantly predicted its use in subsequent admissions (OR 7.62, p < 0.05).
• Pharmacist participation on care teams was a significant predictor of PGx use (OR 4.52, p < 0.05).
• Actionable care team attributes, like pharmacist involvement, predict PGx CDS adoption.

Conclusions:

• Pharmacist participation and prior provider experience are key drivers for inpatient PGx CDS adoption.
• Targeting these actionable attributes can enhance the implementation of personalized medicine through PGx.
• This study provides the first systematic analysis of patient and care team factors influencing inpatient PGx CDS adoption.