Towards the Integration of Precision Medicine in Psychiatric Care Delivery: Evaluating the Impact of Clinical Guidelines on Drug-Related Adverse Events

Abstract

Despite the immense potential of precision medicine to revolutionize healthcare, its integration into routine clinical practice remains a significant challenge. This study investigates the impact of Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines, which provide synthesized evidence and pharmacogenetics-based drug dosing recommendations, on the delivery of psychiatric care enabled by precision medicine. Specifically, we conduct a comprehensive evaluation of the effect of CPIC guidelines on serious drug-related adverse events and explore how drug characteristics related to therapeutic uncertainty, namely drug age and drug label warning, moderate this effect. Our findings suggest that the availability of CPIC guidelines is associated with almost a 25% decrease in serious drug-related adverse events in the context of psychiatric care delivery enabled by precision medicine. Furthermore, we find that the presence of drug label warning, as FDA-endorsed negative news on pharmacogenetics-related drug use, enhances the effect of CPIC guidelines and is associated with a further decrease in serious drug-related adverse events. Post hoc analysis reveals that CPIC guidelines with high strength of evidence are associated with a significant decrease in serious drug-related adverse events, while no such effect is observed for guidelines with low strength of evidence. These findings contribute to the nascent literature on integrating precision medicine into routine clinical practice, highlighting the consequential role of clinical guidelines in improving the effectiveness of psychiatric care delivery for individual patients enabled by precision medicine. In addition, by demonstrating how the development and implementation of robust clinical guidelines are central to minimizing serious drug-related adverse events, the findings have policy implications for minimizing the downside risks of psychiatric care delivery.