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Multisite Investigation of Strategies for the Implementation of CYP2C19 Genotype‐Guided Antiplatelet Therapy
Author(s) -
Empey Philip E.,
Stevenson James M.,
Tuteja Sony,
Weitzel Kristin W.,
Angiolillo Dominick J.,
Beitelshees Amber L.,
Coons James C.,
Duarte Julio D.,
Franchi Francesco,
Jeng Linda J.B.,
Johnson Julie A.,
Kreutz Rolf P.,
Limdi Nita A.,
Maloney Kristin A.,
Owusu Obeng Aniwaa,
Peterson Josh F.,
Petry Natasha,
Pratt Victoria M.,
Rollini Fabiana,
Scott Stuart A.,
Skaar Todd C.,
Vesely Mark R.,
Stouffer George A.,
Wilke Russell A.,
Cavallari Larisa H.,
Lee Craig R.
Publication year - 2018
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt.1006
Subject(s) - turnaround time , medicine , test (biology) , health informatics , informatics , cyp2c19 , early adopter , percutaneous coronary intervention , pharmacogenomics , evidence based practice , process management , medical education , medical physics , knowledge management , computer science , operations management , nursing , business , alternative medicine , engineering , pharmacology , public health , paleontology , electrical engineering , cytochrome p450 , metabolism , myocardial infarction , biology , operating system , pathology
CYP2C19 genotype‐guided antiplatelet therapy following percutaneous coronary intervention is increasingly implemented in clinical practice. However, challenges such as selecting a testing platform, communicating test results, building clinical decision support processes, providing patient and provider education, and integrating methods to support the translation of emerging evidence to clinical practice are barriers to broad adoption. In this report, we compare and contrast implementation strategies of 12 early adopters, describing solutions to common problems and initial performance metrics for each program. Key differences between programs included the test result turnaround time and timing of therapy changes, which are both related to the CYP2C19 testing model and platform used. Sites reported the need for new informatics infrastructure, expert clinicians such as pharmacists to interpret results, physician champions, and ongoing education. Consensus lessons learned are presented to provide a path forward for those seeking to implement similar clinical pharmacogenomics programs within their institutions.