Journal
CLINICAL PHARMACOLOGY & THERAPEUTICS
Volume 108, Issue 2, Pages 368-376Publisher
WILEY
DOI: 10.1002/cpt.1838
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Funding
- National Institutes of Health (NIH) [K23 GM 100288-01A1]
- University of Chicago Comprehensive Cancer Center
- University of Chicago Bucksbaum Institute for Clinical Excellence Pilot Award
- Central Society for Clinical and Translational Research-Early Career Development Award
- Benjamin McAllister Scholar Program
- NIH [5T35DK062719-28]
- William F. O'Connor Foundation
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Poor adherence is associated with worse disease outcomes. Pharmacogenomics provides a possible intervention to address adherence. We hypothesized that pharmacogenomic-informed care could increase adherence. Patients in a prospective case-control study underwent preemptive pharmacogenomic genotyping with results available for provider use at the point of care; controls (not genotyped) were treated by the same providers. Over 6,000 e-prescriptions for 39 medications with actionable pharmacogenomic information were analyzed. Composite adherence, measured by modified proportion of days covered (mPDC), was compared between cases/controls and genomically concordant vs. genomically higher-risk medications. Overall, 536 patients were included. No difference in mean mPDC was observed due to availability of pharmacogenomic guidance. However, case patients prescribed high-risk pharmacogenomic medications were more than twice as likely to have low mPDC for these medications compared with genomically concordant prescriptions (odds ratio = 2.4 (1.03-5.74), P < 0.05). This study is the first to show that composite pharmacogenomic information predicts adherence.
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