Mathias P C, Hendrix N, Wang W-J, Keyloun K, Khelifi M, Tarczy-Hornoch P, Devine B
Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA.
Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle, Washington, USA.
Clin Pharmacol Ther. 2017 Aug;102(2):340-348. doi: 10.1002/cpt.611. Epub 2017 Jun 5.
The extent to which pharmacogenomic-guided medication use has been adopted in various health systems is unclear. To assess the uptake of pharmacogenomic-guided medication use, we determined its frequency across our health system, which does not have a structured testing program. Using a multisite clinical data repository, we identified adult patients' first prescribed medications between January 2011 and December 2013 and investigated the frequency of germline and somatic pharmacogenomic testing, by the Pharmacogenomics Knowledgebase level of the US Food and Drug Administration label information. There were 268,262 medication orders for drugs with germline pharmacogenomic testing information in their drug labels. Pharmacogenomic testing was detected for 1.5% (129/8,718) of medication orders with recommended or required testing. Of the 3,817 medication orders associated with somatic pharmacogenomic testing information in their drug labels, 20% (372/1,819) of required tests were detected. The low rates of detectable pharmacogenomic testing suggest that structured testing programs are required to achieve the success of precision medicine.
药物基因组学指导用药在不同卫生系统中的采用程度尚不清楚。为评估药物基因组学指导用药的应用情况，我们在没有结构化检测项目的卫生系统中，确定了其在整个系统中的使用频率。利用多中心临床数据储存库，我们确定了2011年1月至2013年12月期间成年患者首次开具的药物，并根据美国食品药品监督管理局标签信息的药物基因组学知识库水平，调查了种系和体细胞药物基因组学检测的频率。药物标签中有268,262份药物订单涉及种系药物基因组学检测信息。在推荐或要求检测的药物订单中，有1.5%（129/8,718）检测到了药物基因组学检测。在药物标签中与体细胞药物基因组学检测信息相关的3,817份药物订单中，检测到了20%（372/1,819）的要求检测。可检测的药物基因组学检测率较低，这表明需要结构化检测项目才能实现精准医疗的成功。
