Implementing a personalized medicine program in a community health system

The implementation of a personalized medicine program in a rural community health system serving an underserved population is described. Focusing on the safe use of drugs impacted by genetic variations in the non-oncology setting, we first addressed drug-gene pairs designated by the US FDA in black-...

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Bibliographic Details
Published in:Pharmacogenomics 2018-11, Vol.19 (17), p.1345-1356
Main Authors: Dressler, Lynn G, Bell, Gillian C, Ruch, Karl D, Retamal, Jennifer D, Krug, Paige B, Paulus, Ronald A
Format: Article
Language:English
Subjects:
Abacavir
Acquired immune deficiency syndrome
Acute coronary syndromes
AIDS
Carbamazepine
Clopidogrel
Codeine
Community Health Planning - methods
community health system
Consortia
dissemination science
Drug dosages
Drug Labeling - methods
Emergency medical care
Genetic diversity
Genetic Variation - genetics
Genetics
Health care policy
HIV
Hospitals
Human immunodeficiency virus
Humans
implementation science
Informatics
Leadership
Medical records
Oncology
Outpatients
Patient safety
Pediatrics
personalized medicine
pharmacogenetics
Pharmacogenetics - methods
Pharmacogenomic Testing - methods
pharmacogenomics
Pharmacy
Pilot Projects
Precision medicine
Precision Medicine - methods
Primary care
United States
United States Food and Drug Administration
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Description
Summary:The implementation of a personalized medicine program in a rural community health system serving an underserved population is described. Focusing on the safe use of drugs impacted by genetic variations in the non-oncology setting, we first addressed drug-gene pairs designated by the US FDA in black-box warnings (codeine, clopidogrel, abacavir, carbamazepine). The program's first success was a policy change to remove codeine from the pediatric formulary, rather than a testing recommendation. Pilot studies were then conducted with primary care providers to get them familiar with pharmacogenetic testing, and a consultative outpatient clinic for patients was developed. The assessment, planning, implementation, challenges, successes and lessons learned are described.
ISSN:1462-2416
1744-8042
DOI:10.2217/pgs-2018-0130