Open AccessChanging from mandatory to optional genotyping results in higher acceptance of pharmacist-guided warfarin dosing
Author(s) -
Ashwini Zolekar,
Kibum Kim,
James C Lee,
Jin Han,
Julio D. Duarte,
William L. Galanter,
Larisa H. Cavallari,
Edith A. Nutescu
Publication year - 2022
Publication title -
pharmacogenomics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.541
H-Index - 91
eISSN - 1744-8042
pISSN - 1462-2416
DOI - 10.2217/pgs-2021-0109
Subject(s) - genotyping , dosing , medicine , warfarin , vkorc1 , pharmacist , family medicine , cyp2c9 , genotype , pharmacy , genetics , cytochrome p450 , metabolism , gene , biology , atrial fibrillation
Aim: We evaluated the clinical acceptance and feasibility of a pharmacist-guided personalized consult service following its transition from a mandatory (mPGx) to optional (oPGx) CYP2C9/ VKORC1/ CYP4F2 genotyping for warfarin. Methods: A total of 1105 patients were included. Clinical acceptance and feasibility outcomes were analyzed using bivariate and multivariable analyses. Results: After transitioning to optional genotyping, genotype testing was still ordered in a large segment of the eligible population (52.1%). Physician acceptance of pharmacist-recommended doses improved from 83.9% (mPGx) to 86.6% (oPGx; OR: 1.3; 95% CI: 1.1–1.5; p = 0.01) with a shorter median genotype result turnaround time (oPGX: 23.6 h vs mPGX: 25.1 h; p < 0.01). Conclusion: Ordering of genotype testing and provider acceptance of dosing recommendations remained high after transitioning to optional genotyping.