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ABSTRACT:
SUBMITTER: Arkin AP
PROVIDER: S-EPMC6870991 | biostudies-literature | 2018 Jul
REPOSITORIES: biostudies-literature
Publications
KBase: The United States Department of Energy Systems Biology Knowledgebase.
Arkin Adam P AP Cottingham Robert W RW Henry Christopher S CS Harris Nomi L NL Stevens Rick L RL Maslov Sergei S Dehal Paramvir P Ware Doreen D Perez Fernando F Canon Shane S Sneddon Michael W MW Henderson Matthew L ML Riehl William J WJ Murphy-Olson Dan D Chan Stephen Y SY Kamimura Roy T RT Kumari Sunita S Drake Meghan M MM Brettin Thomas S TS Glass Elizabeth M EM Chivian Dylan D Gunter Dan D Weston David J DJ Allen Benjamin H BH Baumohl Jason J Best Aaron A AA Bowen Ben B Brenner Steven E SE Bun Christopher C CC Chandonia John-Marc JM Chia Jer-Ming JM Colasanti Ric R Conrad Neal N Davis James J JJ Davison Brian H BH DeJongh Matthew M Devoid Scott S Dietrich Emily E Dubchak Inna I Edirisinghe Janaka N JN Fang Gang G Faria José P JP Frybarger Paul M PM Gerlach Wolfgang W Gerstein Mark M Greiner Annette A Gurtowski James J Haun Holly L HL He Fei F Jain Rashmi R Joachimiak Marcin P MP Keegan Kevin P KP Kondo Shinnosuke S Kumar Vivek V Land Miriam L ML Meyer Folker F Mills Marissa M Novichkov Pavel S PS Oh Taeyun T Olsen Gary J GJ Olson Robert R Parrello Bruce B Pasternak Shiran S Pearson Erik E Poon Sarah S SS Price Gavin A GA Ramakrishnan Srividya S Ranjan Priya P Ronald Pamela C PC Schatz Michael C MC Seaver Samuel M D SMD Shukla Maulik M Sutormin Roman A RA Syed Mustafa H MH Thomason James J Tintle Nathan L NL Wang Daifeng D Xia Fangfang F Yoo Hyunseung H Yoo Shinjae S Yu Dantong D
Nature biotechnology 20180701 7
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Project description:IntroductionEmergency departments (ED) use many medications with a range of therapeutic efficacy and potential significant side effects, and many medications have dosage adjustment recommendations based on the patient's specific genotype. How frequently medications with such pharmaco-genetic recommendations are used in United States (US) EDs has not been studied.MethodsWe conducted a cross-sectional analysis of the 2010-2015 National Hospital Ambulatory Medical Care Survey (NHAMCS). We reported the proportion of ED visits in which at least one medication with Clinical Pharmacogenetics Implementation Consortium (CPIC) recommendation of Level A or B evidence was ordered. Secondary comparisons included distributions and 95% confidence intervals of age, gender, race/ethnicity, ED disposition, geographical region, immediacy, and insurance status between all ED visits and those involving a CPIC medication.ResultsFrom 165,155 entries representing 805,726,000 US ED visits in the 2010-2015 NHAMCS, 148,243,000 ED visits (18.4%) led to orders of CPIC medications. The most common CPIC medication was tramadol (6.3%). Visits involving CPIC medications had higher proportions of patients who were female, had private insurance and self-pay, and were discharged from the ED. They also involved lower proportions of patients with Medicare and Medicaid.ConclusionAlmost one fifth of US ED visits involve a medication with a pharmacogenetic recommendation that may impact the efficacy and toxicity for individual patients. While direct application of genotyping is still in development, it is important for emergency care providers to understand and support this technology given its potential to improve individualized, patient-centered care.
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