Acceptance of recommendations by a pharmacogenetics clinic

Assess the acceptance of genotype-based pharmacist recommendations made within a pharmacogenetics (PGx) clinic.

Patients seen by the UF Health PGx clinic between 2017 and 2022 were included in a retrospective chart review. We evaluated CYP2D6/CYP2C19 and three drug classes (opioids, selective serotonin reuptake inhibitors [SSRIs], proton pump inhibitors [PPIs]). Gene-drug pairings were classified as concordant/discordant based on pharmacist recommendations, derived from guidelines. The concordance was compared between baseline, or time that PGx results were available, at 3- and 12-months after the visit. Acceptance of recommendations was inferred by a reduction in discordant gene-drug pairs.

201 patients with PGx results were seen at the clinic. There were 101 relevant prescriptions at baseline; of these 50 (50%) were discordant based on CYP2C19/CYP2D6 phenotypes. This decreased to 22 (22%); acceptance rate = 56% at 3-months (28 of 50 recommendations accepted), p-value < 0.05. At baseline, there were 28 SSRIs prescriptions, 18 (64%) were discordant versus 7 (25%) at 3-months; acceptance rate = 61%, p-value < 0.05. Of the 60 PPIs prescriptions at baseline, 25 (42%) were discordant, decreasing to 6 (10%) at 3-months; acceptance rate = 76%, p-value < 0.05.

We observed a reduction in discordant gene-drug pairs as a result of PGx pharmacist recommendations acceptance.