Acceptability, Feasibility, and Utility of Integrating Pharmacogenetic Testing into a Child Psychiatry Clinic.
Acceptability, Feasibility, and Utility of Integrating Pharmacogenetic Testing into a Child Psychiatry Clinic.
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将药物遗传学检测纳入儿童精神科诊所的可接受性、可行性和实用性
DOI：
10.1111/cts.12914
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Mathews CA
中科院分区：
文献类型：
--
作者：
Claudio-Campos K;Padrón A;Jerkins G;Nainaparampil J;Nelson R;Martin A;Wiisanen K;Smith DM;Strekalova Y;Marsiske M;Cicali EJ;Cavallari LH;Mathews CA
药物遗传学（PGx）测试是一种识别不良事件或治疗失败风险较高的患者的工具。对不良副作用的担忧可能会限制药物的依从性，特别是在儿童和青少年中。我们进行了一项务实的研究，以评估的可接受性和可行性，并收集试点数据的效用PGx测试在儿童和青少年精神病学诊所。医生和家庭都参与了这项研究，并回答了调查前和调查后的问卷，以检查他们对PGx检测的态度。患者随机分为实施组（N = 25）和对照组（N = 24），并分别在研究开始或结束时进行PGx检测。向医生提供了临床咨询记录和基因型指导建议，供其在临床决策中考虑。在基线和12周时评估患者报告的症状严重程度和抗抑郁药相关副作用。参与的医生和家庭都同意PGx测试是改善药物选择的有用工具。从样本采集到获得PGx检测结果的时间约为10天，从获得咨询记录到获得咨询记录的时间约为15天，这可能会损害检测在临床决策中的效用。实施组和对照组之间的任何临床终点均无差异;然而，治疗第8周后，CYP 2D 6弱代谢者和中代谢者的抗抑郁药副作用评分较高。我们的研究结果揭示了在真实的临床环境中使用PGx检测的益处和缺陷，这可能会为专注于结局的大型试验提供方法学信息。
Pharmacogenetic (PGx) testing is a tool to identify patients at a higher risk of adverse events or treatment failure. The concern for unwanted side effects can limit medication adherence, particularly in children and adolescents. We conducted a pragmatic study to evaluate the acceptability and feasibility and gather pilot data on the utility of PGx testing in a child and adolescent psychiatry clinic. Both physicians and families participated in the study and answered pre‐survey and post‐survey questionnaires to examine their attitudes toward PGx testing. Patients were randomized into implementation (N = 25) and control groups (N = 24) and underwent PGx testing at the beginning or end of the study, respectively. Clinical consult notes with genotype‐guided recommendations were provided to physicians for their consideration in clinical decisions. Patient‐reported symptom severity and antidepressant‐related side effects were assessed at baseline and for 12 weeks. Both participating physicians and families agreed that PGx testing is a useful tool to improve medication selection. The time from sample collection to having PGx test results was ~ 10 days and 15 days to having consult notes available, which may have impaired test utility in clinical decision making. There were no differences in any clinical end point between the implementation and control arms; however, there were higher antidepressant side effect scores for CYP2D6 poor and intermediate metabolizers after the eighth week of treatment. Our findings revealed benefits and pitfalls with the use of PGx testing in the real‐world clinical setting, which may inform the methodology of a larger trial focused on outcomes.
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影响因子：
3.6
作者：
Foa, EB;Huppert, JD;Salkovskis, PM
通讯作者：
Salkovskis, PM
DOI：
10.1016/j.jpeds.2018.09.021
发表时间：
2019-03
期刊：
The Journal of pediatrics
影响因子：
--
作者：
Ghandour RM;Sherman LJ;Vladutiu CJ;Ali MM;Lynch SE;Bitsko RH;Blumberg SJ
通讯作者：
Blumberg SJ
影响因子：
3.1
作者：
Saiz-Rodriguez, Miriam;Belmonte, Carmen;Abad-Santos, Francisco
通讯作者：
Abad-Santos, Francisco
影响因子：
2.1
作者：
Deininger, Kimberly M.;Tsunoda, Shirley M.;Aquilante, Christina L.
通讯作者：
Aquilante, Christina L.
影响因子：
3.5
作者：
Christensen, K. D.;Vassy, J. L.;McGuire, A. L.
通讯作者：
McGuire, A. L.