Pharmacogenetic polymorphism as an independent risk factor for frequent hospitalizations in older adults with polypharmacy: a pilot study

Figures & data

Figure 1 Hospitalization risk factors.

Figure 2 Study design.

Abbreviations: CVD, cardiovascular disease; PGx, pharmacogenetic.

Table 1 Sociodemographic characteristics of cases and controls

Parameters	Cases	Controls
Age (mean ± SD), years	77.2±5.0	78.3±5.1
Gender (%)	M =67; F =33	M =67; F =33
Race (%)	W =83; B =17	W =83; B =17
Ethnicity (%)	H =67; NH =33	H =67; NH =33
Household size (mean ± SD)	2.2±0.4	2.0±0.6
Years in school (mean ± SD)	10.3±2.7	13.2±5.5
Marital status (%)	Married =33; single =67	Married =33; single =67
Country of birth (%)	USA =67; non-USA =33	USA =67; non-USA =33
Full-time employment (%)	0	0
English proficiency (%)	NP =33; GE =67	NP =33; GE =67
Income (%)	<$40K =83; >$40K =17	<$40K =83; >$40K =17
Insurance (%)	MM =100; PHP =17	MM =100; PHP =33

Abbreviations: B, black; F, female; GE, good to excellent; H, Hispanic; M, male; MM, Medicare/Medicaid; NH, non-Hispanic; NP, none to poor; PHP, private health plan; SD, standard deviation; W, white.

Table 2 Clinical and behavioral characteristics of cases and controls

Parameters	Cases	Controls
Chronic disease score (mean ± SD)	7.8±1.2	7.8±1.2
Medication adherence score (mean ± SD)	6.9±1.1	7.0±1.0
Medication adherence self-efficacy (mean ± SD)	2.5±0.5	2.7±0.4
BMI (mean ± SD)	29.2±4.1	29.3±3.1
Current alcohol consumption (%)	0	0
Current smoking (%)	0	0
Former smoker (%)	33	67
Number of comorbid conditions (mean ± SD)	8.2±1.2	8.2±2.0
Number of geriatric syndromes (mean ± SD)	4.0±1.7	3.7±0.5
Symptom severity (%)	NM =17; MS =83	NM =33; MS =67
Overall illness trajectory (%)	P =50; S =50; I =0	P =50; S =33; I =17
Health literacy (%)	Insuf =50; Suf =50	Insuf =50; Suf =50
Number of medications (mean ± SD)	14.3±5.3	14.0±2.9
Number of gene–drug interactions (mean ± SD)	2.8±2.2	0±0§
Number of hospitalizations in 2 years (mean ± SD)	4.8±1.7	0.2±0.4§
Number of hospitalizations in 5 years (mean ± SD)	11.2±9.3	0.8±0.8§

Note:

§ Statistically significant difference between cases and controls (P<0.05).

Abbreviations: BMI, body mass index; I, improving; Insuf, insufficient; MS, moderate to severe; NM, none to mild; P, progressing; S, stable; Suf, sufficient; SD, standard deviation.

Table 3 Results of pharmacogenetic testing

Hospital admissions	Pharmacogenetic profil
	CYP2C19	CYP2C9	VKORC1	CYP2D6	CYP3A4/5
	Cases
High	ENM	ENM	HWS	ENM	PM
High	ENM	ENM	IWS	RM	ENM
High	RM	ENM	IWS	ENM	PM
High	RM	ENM	NWS	ENM	ENM
High	RM	ENM	HWS	ENM	ENM
High	RM	ENM	IWS	ENM	IM
	Controls
Low	ENM	ENM	NWS	ENM	ENM
Low	IM	ENM	NWS	IM	ENM
Low	IM	ENM	NWS	ENM	ENM
Low	IM	ENM	NWS	ENM	ENM
Low	IM	ENM	NWS	IM	ENM
Low	IM	IM	IWS	ENM	ENM

Abbreviations: ENM, extensive/normal metabolizer; HWS, high warfarin sensitivity; IM, intermediate metabolizer; IWS, increased warfarin sensitivity; NWS, normal warfarin sensitivity; PM, poor metabolizer; RM, rapid metabolizer.