دورية أكاديمية
Implementation of CYP2C19 and CYP2D6 genotyping to guide antidepressant use in a large rural health system.
| العنوان: | Implementation of CYP2C19 and CYP2D6 genotyping to guide antidepressant use in a large rural health system. |
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| المؤلفون: | Petry NJ; Sanford Imagenetics, Sanford Health, Sioux Falls, SD, and Department of Pharmacy Practice, North Dakota State University, Fargo, ND, USA., Van Heukelom J; Sanford Imagenetics, Sanford Health, Sioux Falls, SD, and Department of Internal Medicine, University of South Dakota School of Medicine, Vermillion, SD, USA., Schultz AJ; Sanford Imagenetics, Sanford Health, Sioux Falls, SD, and Department of Internal Medicine, University of South Dakota School of Medicine, Vermillion, SD, USA., Jacobsen K; Sanford Imagenetics, Sanford Health, Sioux Falls, SD, USA., Baye JF; Sanford Imagenetics, Sanford Health, Sioux Falls, SD, and South Dakota State University College of Pharmacy and Allied Health Professions, Brookings, SD, USA., Mills S; Sanford Imagenetics, Sanford Health, Sioux Falls, SD, USA., Figueroa DM; Sanford Medical Genetics Laboratory, Sanford Health, Sioux Falls, SD, and Department of Internal Medicine, University of South Dakota School of Medicine, Vermillion, SD, USA., Massmann A; Sanford Imagenetics, Sanford Health, Sioux Falls, SD, and Department of Internal Medicine, University of South Dakota School of Medicine, Vermillion, SD, USA. |
| المصدر: | American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists [Am J Health Syst Pharm] 2024 Aug 12; Vol. 81 (16), pp. 723-732. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 9503023 Publication Model: Print Cited Medium: Internet ISSN: 1535-2900 (Electronic) Linking ISSN: 10792082 NLM ISO Abbreviation: Am J Health Syst Pharm Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2019-> : [Oxford] : Oxford University Press Original Publication: Bethesda, MD : The Society, c1995- |
| مواضيع طبية MeSH: | Cytochrome P-450 CYP2C19*/genetics , Cytochrome P-450 CYP2D6*/genetics , Cytochrome P-450 CYP2D6*/metabolism , Antidepressive Agents*/therapeutic use, Humans ; Genotype ; Pharmacogenomic Testing/methods ; Depression/drug therapy ; Depression/genetics ; Pharmacogenetics ; Decision Support Systems, Clinical ; Electronic Health Records ; Rural Health Services ; Anxiety/drug therapy |
| مستخلص: | Purpose: We describe the implementation and ongoing maintenance of CYP2C19 and CYP2D6 focused pharmacogenetic (PGx) testing to guide antidepressant and antianxiety medication prescriptions in a large rural, nonprofit health system. Summary: Depression and anxiety are common psychiatric conditions. Sanford Health implemented PGx testing for metabolism of cytochrome P450 (CYP) isozymes 2C19 and 2D6 in 2014 to inform prescribing for multiple medications, including antidepressant and antianxiety therapies. As guidelines, genotype to phenotype translation, panel offerings, and other resources are updated, we adapt our approach. We make educational and informational materials available to providers and patients. Pharmacogenomic clinical pharmacists review PGx results with discrete values and provide guidance documentation in the electronic medical record. A robust clinical decision support system is in place to provide interruptive alerts, noninterruptive alerts, and genomic indicators. A referral-based interdisciplinary clinic is also available to provide in-depth education to patients regarding PGx results and implications. Additionally, partnering with our health plan has expanded access to PGx testing for patients with anxiety or depression. Conclusion: The implementation and maintenance of Sanford Health's PGx program to guide antidepressant and antianxiety medication use continues to evolve and requires a multipronged approach relying on both human and informatics-based resources. (© American Society of Health-System Pharmacists 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
| فهرسة مساهمة: | Keywords: CYP2C19; CYP2D6; anxiety; clinical decision support systems; clinical implementation; cytochrome P450 isozyme 2C19; cytochrome P450 isozyme 2D6; depression; pharmacogenetics |
| المشرفين على المادة: | EC 1.14.14.1 (Cytochrome P-450 CYP2C19) EC 1.14.14.1 (Cytochrome P-450 CYP2D6) 0 (Antidepressive Agents) EC 1.14.14.1 (CYP2C19 protein, human) |
| تواريخ الأحداث: | Date Created: 20240328 Date Completed: 20240812 Latest Revision: 20240812 |
| رمز التحديث: | 20240813 |
| DOI: | 10.1093/ajhp/zxae083 |
| PMID: | 38546726 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1535-2900 |
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| DOI: | 10.1093/ajhp/zxae083 |