Evaluation of pharmacogenetic automated clinical decision support for clopidogrel.

IF 1.9 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacogenomics Pub Date : 2024-01-01 Epub Date: 2024-09-11 DOI:10.1080/14622416.2024.2394014

Amanda Massmann, Joel Van Heukelom, Max Weaver, April Schultz, Debbie M Figueroa, Adam Stys, Tomasz P Stys, Kurt D Christensen

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Abstract

Aim: Clopidogrel requires CYP2C19 activation to have antiplatelet effects. Pharmacogenetic testing to identify patients with impaired CYP2C19 function can be coupled with clinical decision support (CDS) alerts to guide antiplatelet prescribing. We evaluated the impact of alerts on clopidogrel prescribing.Materials & methods: We retrospectively analyzed data for 866 patients in which CYP2C19-clopidogrel CDS was deployed at a single healthcare system during 2015-2023.Results: Analyses included 2,288 alerts. CDS acceptance rates increased from 24% in 2015 to 63% in 2023 (p < 0.05). Adjusted analyses also showed higher acceptance rates when clopidogrel had been ordered for a percutaneous intervention (OR: 28.7, p < 0.001) and when cardiologists responded to alerts (OR: 2.11, p = 0.001).Conclusion: CDS for CYP2C19-clopidogrel was effective in reducing potential drug-gene interactions. Its influence varied by clinician specialty and medication indications.

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评估氯吡格雷的药物基因自动临床决策支持。

目的：氯吡格雷需要 CYP2C19 激活才能发挥抗血小板作用。识别 CYP2C19 功能受损患者的药物基因检测可与临床决策支持（CDS）警报相结合，以指导抗血小板处方。我们评估了警报对氯吡格雷处方的影响：我们回顾性分析了2015-2023年间在一个医疗系统中部署了CYP2C19-氯吡格雷CDS的866名患者的数据：分析包括2288个警报。CDS接受率从2015年的24%增至2023年的63%（P P = 0.001）：CYP2C19-氯吡格雷的CDS能有效减少潜在的药物基因相互作用。其影响因临床医生的专业和药物适应症而异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacogenomics 医学-药学

CiteScore

3.40

自引率

9.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Pharmacogenomics (ISSN 1462-2416) is a peer-reviewed journal presenting reviews and reports by the researchers and decision-makers closely involved in this rapidly developing area. Key objectives are to provide the community with an essential resource for keeping abreast of the latest developments in all areas of this exciting field. Pharmacogenomics is the leading source of commentary and analysis, bringing you the highest quality expert analyses from corporate and academic opinion leaders in the field.