Improving prescribing: a feasibility study of pharmacogenetic testing with clinical decision support in primary healthcare in Singapore.

IF 2.4 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Family practice Pub Date : 2024-08-14 DOI:10.1093/fampra/cmac124

Helen Smith, Martin Dawes, Hagit Katzov-Eckert, Sarah Burrell, Sam Xin Hui, Michael D Winther

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引用次数: 0

Abstract

Background: The study of genetic variation as a factor influencing drug safety, efficacy, and effectiveness has brought about significant breakthroughs in understanding the clinical application of gene-drug interactions to better manage drug therapy.

Objective: This study was designed to assess the feasibility of collecting buccal samples by general practitioners (GPs) at private practices in Singapore within a usual consultation, incorporating use of a pharmacogenetics-based medical decision support system to guide subsequent drug dosing.

Methods: We used a prospective cohort study design, with GPs recruiting 189 patients between October 2020 and March 2021. The genotypes of 51 biallelic SNPs were determined using Illumina Infinium Global Screening Array.

Results: Seven GPs from 6 private practices recruited and obtained buccal samples from a total of 189 patients. All patients had at least one actionable variant. The prevalence of patients having 2, 3, or 4 variants was 37.0%, 32.8%, and 12.7%, respectively. Potential alterations to medications were identified using the Clinical Decision Support System. Patients were accepting and the GPs were enthusiastic about the potential of pharmacogenetics to personalize medicine for their patients.

Conclusion: This is the first study in Singapore to demonstrate the feasibility of pharmacogenetic testing in primary care. The high prevalence of genetic variants underscores the potential use of pharmacogenetics in this setting.

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改善处方：在新加坡初级医疗保健中使用临床决策支持进行药物基因检测的可行性研究。

背景：基因变异是影响药物安全性、药效和有效性的因素：基因变异是影响药物安全性、药效和有效性的一个因素，对基因与药物相互作用的临床应用的研究为更好地管理药物治疗带来了重大突破：本研究旨在评估新加坡私人诊所的全科医生（GPs）在常规咨询中收集口腔样本的可行性，并结合使用基于药物遗传学的医疗决策支持系统来指导后续用药：我们采用了前瞻性队列研究设计，全科医生在 2020 年 10 月至 2021 年 3 月间招募了 189 名患者。结果：来自 6 家私人诊所的 7 名全科医生招募了 189 名患者：来自 6 家私人诊所的 7 名全科医生招募并获取了 189 名患者的口腔样本。所有患者都有至少一个可操作的变异。拥有 2、3 或 4 个变异体的患者比例分别为 37.0%、32.8% 和 12.7%。使用临床决策支持系统确定了药物的潜在改变。对于药物遗传学为患者提供个性化药物的潜力，患者表示接受，全科医生也表现出了极大的热情：这是新加坡第一项证明药物基因检测在初级保健中可行性的研究。基因变异的高流行率凸显了药物基因学在这一领域的潜在用途。

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

Family practice 医学-医学：内科

CiteScore

4.30

自引率

9.10%

发文量

144

审稿时长

4-8 weeks

期刊介绍： Family Practice is an international journal aimed at practitioners, teachers, and researchers in the fields of family medicine, general practice, and primary care in both developed and developing countries. Family Practice offers its readership an international view of the problems and preoccupations in the field, while providing a medium of instruction and exploration. The journal''s range and content covers such areas as health care delivery, epidemiology, public health, and clinical case studies. The journal aims to be interdisciplinary and contributions from other disciplines of medicine and social science are always welcomed.