Early Adoption of Pharmacogenetic Testing for Veterans Prescribed Psychotropic Medications

Abstract

Aim: Describe the characteristics of providers ordering, patients receiving, and clinical impact of a psychotropic pharmacogenetic test on veteran care. Patients & methods: Observational cohort study linking veterans’ laboratory results to electronic health record data. Changes in psychotropic medication prescribing were measured as a function of test results. Results: A total of 38 providers tested 181 veterans between 10/6/2014 and 2/1/2018. Prescriptions for medications with severe gene–drug interactions decreased; however, 11 such medications were used after testing. For 43 patients, documentation of the results was missing. Conclusion: Most prescribing decisions were congruent with test results, but in a nontrivial number of cases, prescribers appeared not to act on the results. Poor result documentation impeded the potential of results to inform clinical care.

Keywords::

• pharmacogenetic testing
• psychotropic medications
• veterans

Financial & competing interest disclosure

LE Hull is supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Health Services Research, the Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System. Authors SL DuVall, JA Lynch, DW Oslin and JM Pyne received funding support from a VA Office of Research and Development award to DW Oslin (SDR 16-348; ClinicalTrials. gov ID: NCT03170362). This work was supported using resources and facilities at the VA Informatics and Computing Infrastructure (VINCI), VA HSR RES 13-457. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Disclaimer

The views expressed in this article are those of the author(s) and do not necessarily represent the views of the Department of Veterans Affairs.

Additional information

Funding

LE Hull is supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Health Services Research, the Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System. Authors SL DuVall, JA Lynch, DW Oslin and JM Pyne received funding support from a VA Office of Research and Development award to DW Oslin (SDR 16-348; ClinicalTrials. gov ID: NCT03170362). This work was supported using resources and facilities at the VA Informatics and Computing Infrastructure (VINCI), VA HSR RES 13-457. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.