Difference between revisions of "Development and use of active clinical decision support for preemptive pharmacogenomics"
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| − | Using the St. Judes PG4KDS protocol, samples were collected and approximately 225 results were placed in the EHR | + | Using the St. Judes PG4KDS protocol, samples were collected and approximately 225 results were placed in the EHR in order to make recommendations based on the gene-drug pair. Recommendations are based on CPIC guidelines. Once determined they are then placed into the EHR system as such pairs. The CDS is activated when a physician orders a medication that could potentially be high risk based on the pharmocogenetic test results.<ref name="Bell 2013"></ref> This warning can serve different purposes: it can suggest a different medication type altogether or perhaps suggest a change in the standard dose. |
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===Results=== | ===Results=== | ||
Revision as of 22:57, 3 March 2015
Prescribing medication is changing and with the help of CDS and EHR there will be more and more "gene-based drug prescribing". [1]
Background
Many institutions have CDS as part of their EHR; however, few institutions perform pharmacogenetics testing and use this information to prescribe medication. This institution is looking at patients who have been genetically tested and have their results stored in the EHR. Alerts are generated based on the medication prescribed and whether the medication is a high-risk medication for the patient. If considered a high-risk medication, the CDS alerts the physician and prompts the physician to consider prescribing a medication with fewer risks or one that is potentially more efficacious. The CDS may also recommend decreasing or increasing the dose based on the patient's ability to metabolize the drug.
Methods
Using the St. Judes PG4KDS protocol, samples were collected and approximately 225 results were placed in the EHR in order to make recommendations based on the gene-drug pair. Recommendations are based on CPIC guidelines. Once determined they are then placed into the EHR system as such pairs. The CDS is activated when a physician orders a medication that could potentially be high risk based on the pharmocogenetic test results.[1] This warning can serve different purposes: it can suggest a different medication type altogether or perhaps suggest a change in the standard dose.
Results
During an 18month period of information collection and new alerts implemented it was ultimately found that the alerts were not being ignored and the correct medication and dosage was being prescribed. It was found that approximately "95% patients who had a post-test alert at the time of the first prescription received the appropriate change in therapy as guided by the on-screen alert."[1]
Conclusion
Implementing a CDS system that delivers real time alerts based on the pharmocgenetic testing results in a higher incidence of appropriate mediation administration. This has helped physicians to be proactive when prescribing medication from dosing to perhaps even changing the course of therapy.
Comments
This is new information for me and this is exciting in the way of how medicine is continuously evolving. It is a privilege to see how medicine and modern day technology making advancements in patient therapy and treatment. As always, it makes me wonder where will we be in the next 5-10 years!
References
- ↑ 1.0 1.1 1.2 Bell GC, Crews KR, Wilkinson MR, Haidar CE, Hicks JK, Baker DK, Kornegary NM, Wenjian Y, Cross SJ, Howard SC, Freimuth RR, Evans WE, Broeckel U, Relling MV, Hoffman JM, 26 August 2013, Development and use of active clinical decision support for preemptive pharmacogenomics, Journal of the American Medical Informatics Association, 2014,21, 93-99. http://jamia.oxfordjournals.org/content/21/e1/e93
