Estimating the potential impact of implementing pre-emptive pharmacogenetic testing in primary care across the UK

Youssef, Essra, Kirkdale, Charlotte L., Wright, David, Guchelaar, Henk-Jan and Thornley, Tracey (2021) Estimating the potential impact of implementing pre-emptive pharmacogenetic testing in primary care across the UK. British Journal of Clinical Pharmacology, 87 (7). pp. 2907-2925. ISSN 0306-5251

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Aims: Pharmacogenetics (PGx) in the UK is currently implemented in secondary care for a small group of high‐risk medicines. However, most prescribing takes place in primary care, with a large group of medicines influenced by commonly occurring genetic variations. The goal of this study is to quantitatively estimate the volumes of medicines impacted by implementation of a population‐level, pre‐emptive pharmacogenetic screening programme for nine genes related to medicines frequently dispensed in primary care in 2019. Methods: A large community pharmacy database was analysed to estimate the national incidence of first prescriptions for 56 PGx drugs used in the UK for the period 1 January–31 December 2019. These estimated prescription volumes were combined with phenotype frequency data to estimate the occurrence of actionable drug–gene interactions (DGI) in daily practice in community pharmacies. Results: In between 19.1 and 21.1% (n = 5 233 353–5 780 595) of all new prescriptions for 56 drugs (n = 27 411 288 new prescriptions/year), an actionable drug–gene interaction (DGI) was present according to the guidelines of the Dutch Pharmacogenetics Working Group and/or the Clinical Pharmacogenetics Implementation Consortium. In these cases, the DGI would result in either increased monitoring, guarding against a maximum ceiling dose or an optional or immediate drug/dose change. An immediate dose adjustment or change in drug regimen accounted for 8.6–9.1% (n = 2 354 058–2 500 283) of these prescriptions. Conclusions: Actionable drug–gene interactions frequently occur in UK primary care, with a large opportunity to optimise prescribing.

Item Type: Article
Uncontrolled Keywords: community pharmacy,medicines optimisation,pharmacogenetics,pharmacogenomics,pharmacology,pharmacology (medical) ,/dk/atira/pure/subjectarea/asjc/3000/3004
Faculty \ School: Faculty of Science > School of Pharmacy
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Faculty of Science > Research Groups > Patient Care
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Depositing User: LivePure Connector
Date Deposited: 16 Jan 2021 00:53
Last Modified: 21 May 2024 12:30
DOI: 10.1111/bcp.14704


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