Physician Response to Implementation of Genotype-Tailored Antiplatelet Therapy

Peterson, Josh F.; Field, Julie R.; Unertl, Kim; Schildcrout, Jonathan S.; Johnson, Daniel C.; Shi, Yaping; Danciu, Ioana; Cleator, John H.; Pulley, Jill M.; McPherson, John A.; Denny, Josh C.; Laposata, Michael; Roden, Dan M.; Johnson, Kevin B.

doi:10.1002/cpt.331

Back to Previous Page

- Add this to...
- Twitter
- Facebook
- Google Bookmarks
- LinkedIn

Physician Response to Implementation of Genotype-Tailored Antiplatelet Therapy

Published Date:

Feb 17 2016

Publisher's site:

http://dx.doi.org/10.1002/cpt.331 New Site Icon

Source:

Clin Pharmacol Ther. 100(1):67-74.

[PDF-255.38 KB]

Details:

Personal Authors:

Peterson, Josh F. ; Field, Julie R. ; Unertl, Kim ; Schildcrout, Jonathan S. ; Johnson, Daniel C. ; ... More ▼

Keywords:

[+]

Pubmed ID:

26693963

Pubmed Central ID:

PMC4899238

Description:

Physician responses to genomic information are vital to the success of precision medicine initiatives. We prospectively studied a pharmacogenomics implementation program for the propensity of clinicians to select antiplatelet therapy based on CYP2C19 loss-of-function variants in stented patients. Among 2,676 patients, 514 (19.2%) were found to have a CYP2C19 variant affecting clopidogrel metabolism. For the majority (93.6%) of the cohort, cardiologists received active and direct notification of CYP2C19 status. Over 12 months, 57.6% of poor metabolizers and 33.2% of intermediate metabolizers received alternatives to clopidogrel. CYP2C19 variant status was the most influential factor impacting the prescribing decision (hazard ratio [HR] in poor metabolizers 8.1, 95% confidence interval [CI] [5.4, 12.2] and HR 5.0, 95% CI [4.0, 6.3] in intermediate metabolizers), followed by patient age and type of stent implanted. We conclude that cardiologists tailored antiplatelet therapy for a minority of patients with a CYP2C19 variant and considered both genomic and nongenomic risks in their clinical decision-making.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Funding:

U01 HL105198/HL/NHLBI NIH HHS/United States
U01 HG007253/HG/NHGRI NIH HHS/United States
UL1 TR000445/TR/NCATS NIH HHS/United States
U01 HL122904/HL/NHLBI NIH HHS/United States
U19 HL065962/HL/NHLBI NIH HHS/United States
U47 CI000824/CI/NCPDCID CDC HHS/United States
U01 HG008672/HG/NHGRI NIH HHS/United States
U01 HG006378/HG/NHGRI NIH HHS/United States

Main Document Checksum:

[+]

Supporting Files:

	nihms746945f4.gif	image/gif
	nihms746945f4.jpg	image/jpeg
	NIHMS746945-supplement-Supp_Table_S1.docx	application/vnd.openxmlformats-officedocument.wordprocessingml.document
	nihms746945.nxml	application/octet-stream
	nihms746945f1.gif	image/gif
	nihms746945f1.jpg	image/jpeg
	nihms746945f2.gif	image/gif
	nihms746945f2.jpg	image/jpeg
	nihms746945f3.gif	image/gif
	nihms746945f3.jpg	image/jpeg

No Related Documents.

You May Also Like:

Electronic Health Record Design and Implementation for Pharmacogenomics: a Local Perspective

Personal Author:

Peterson, Josh F.; Bowton, Erica; Field, Julie R.; Beller, Marc; Mitchell, Jennifer; Schildcrout, Jonathan; Gregg, William; Johnson, Kevin; Jirjis, Jim N; Roden, Dan M.; Pulley, Jill M.; Denny, Josh C.;

Published:

Sep 05 2013

Source:

Genet Med. 15(10):833-841.

Description:

Purpose : The design of electronic health records (EHR) to translate genomic medicine into clinical care is crucial to successful introduction of new genomic services, yet there are few published guides to implementation. : Methods : The design, impl...

File Type:

[PDF - 571.46 KB]
Clinician Perspectives on Using Pharmacogenomics in Clinical Practice

Personal Author:

Unertl, Kim M.; Jaffa, Habiba; Field, Julie R.; Price, Lisa; Peterson, Josh F.;

Published:

2015

Source:

Per Med. 12(4):339-347

Description:

Aim : To describe the knowledge and attitudes of clinicians participating in a large pharmacogenomics implementation program. : Materials & methods : Semi-structured interviews with 15 physicians and nurse practitioners were conducted. : Results : Th...

File Type:

[PDF - 83.19 KB]
Attitudes of Clinicians Following Large-Scale Pharmacogenomics Implementation

Personal Author:

Peterson, Josh F.; Field, Julie R.; Shi, Yaping; Schildcrout, Jonathan S.; Denny, Joshua C.; McGregor, Tracy L.; Van Driest, Sara L.; Pulley, Jill M.; Lubin, Ira M.; Laposata, Michael; Roden, Dan M.; Clayton, Ellen W.;

Published:

Aug 11 2015

Source:

Pharmacogenomics J. 16(4):393-398.

Description:

Clinician attitudes toward multiplexed genomic testing may be vital to the success of translational programs. We surveyed clinicians at an academic medical center about their views on a large pharmacogenomics implementation, the PREDICT (Pharmacogeno...

File Type:

[PDF - 801.99 KB]
Use of selected clinical preventive services among adults--United States, 2007-2010

Corporate Author:

Centers for Disease Control and Prevention (U.S.)

Published:

June 15, 2012

Series:

MMWR. Morbidity and mortality weekly report ; v. 61, suppl. (June 15, 2012)

Description:

"CDC has a long history of monitoring the use of clinical preventive services to provide public health agencies, health care providers and their partners information needed to plan and implement programs that increase use of these services and improv...

File Type:

[PDF - 64.41 MB]
Prehospital Triage of Older Adults with Head Injury: A Retrospective Study of the Impact of Adding “Anticoagulation or Antiplatelet Medication Use” as a Criterion

Personal Author:

Nishijima, Daniel K.; Gaona, Samuel; Waechter, Trent; Maloney, Ric; Bair, Troy; Blitz, Adam; Elms, Andrew R.; Farrales, Roel D.; Howard, Calvin; Montoya, James; Bell, Jeneita M.; Faul, Mark; Vinson, David R.; Holmes, James F.; Ballard, Dustin W.;

Corporate Author:

for the Sacramento County Prehospital Research Consortium

Published:

Feb 24 2017

Source:

Ann Emerg Med. 70(2):127-138.e6.

Description:

Study Objective : Field triage guidelines recommend EMS providers consider transport of head injured older adults with anticoagulation use to trauma centers. However the triage patterns and the incidence of intracranial hemorrhage or neurosurgery in ...

File Type:

[PDF - 208.84 KB]