Multisite evaluation of institutional processes and implementation determinants for pharmacogenetic testing to guide antidepressant therapy
Salloum, Ramzi G
Elchynski, Amanda L
Smith, D Max
Blake, Kathryn V
Limdi, Nita A
Aquilante, Christina L
Beitelshees, Amber L
Duong, Benjamin Q
Empey, Philip E
Formea, Christine M
Hicks, J Kevin
Pasternak, Amy L
Ramsey, Laura B
Swain, Sandra M
Ward, Kristen M
Skaar, Todd C
Van Driest, Sara L
Cavallari, Larisa H
Bishop, Jeffrey R
JournalClinical and Translational Science
MetadataShow full item record
AbstractThere is growing interest in utilizing pharmacogenetic (PGx) testing to guide antidepressant use, but there is lack of clarity on how to implement testing into clinical practice. We administered two surveys at 17 sites that had implemented or were in the process of implementing PGx testing for antidepressants. Survey 1 collected data on the process and logistics of testing. Survey 2 asked sites to rank the importance of Consolidated Framework for Implementation Research (CFIR) constructs using best-worst scaling choice experiments. Of the 17 sites, 13 had implemented testing and four were in the planning stage. Thirteen offered testing in the outpatient setting, and nine in both outpatient/inpatient settings. PGx tests were mainly ordered by psychiatry (92%) and primary care (69%) providers. CYP2C19 and CYP2D6 were the most commonly tested genes. The justification for antidepressants selected for PGx guidance was based on Clinical Pharmacogenetics Implementation Consortium guidelines (94%) and US Food and Drug Administration (FDA; 75.6%) guidance. Both institutional (53%) and commercial laboratories (53%) were used for testing. Sites varied on the methods for returning results to providers and patients. Sites were consistent in ranking CFIR constructs and identified patient needs/resources, leadership engagement, intervention knowledge/beliefs, evidence strength and quality, and the identification of champions as most important for implementation. Sites deployed similar implementation strategies and measured similar outcomes. The process of implementing PGx testing to guide antidepressant therapy varied across sites, but key drivers for successful implementation were similar and may help guide other institutions interested in providing PGx-guided pharmacotherapy for antidepressant management. © 2021 The Authors.
Rights/Terms© 2021 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of the American Society for Clinical Pharmacology and Therapeutics.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/16782
- Best-worst scaling methodology to evaluate constructs of the Consolidated Framework for Implementation Research: application to the implementation of pharmacogenetic testing for antidepressant therapy.
- Authors: Salloum RG, Bishop JR, Elchynski AL, Smith DM, Rowe E, Blake KV, Limdi NA, Aquilante CL, Bates J, Beitelshees AL, Cipriani A, Duong BQ, Empey PE, Formea CM, Hicks JK, Mroz P, Oslin D, Pasternak AL, Petry N, Ramsey LB, Schlichte A, Swain SM, Ward KM, Wiisanen K, Skaar TC, Van Driest SL, Cavallari LH, Tuteja S
- Issue date: 2022 May 14
- Retrospective Review of Pharmacogenetic Testing at an Academic Children's Hospital.
- Authors: Roberts TA, Wagner JA, Sandritter T, Black BT, Gaedigk A, Stancil SL
- Issue date: 2021 Jan
- Review and Consensus on Pharmacogenomic Testing in Psychiatry.
- Authors: Bousman CA, Bengesser SA, Aitchison KJ, Amare AT, Aschauer H, Baune BT, Asl BB, Bishop JR, Burmeister M, Chaumette B, Chen LS, Cordner ZA, Deckert J, Degenhardt F, DeLisi LE, Folkersen L, Kennedy JL, Klein TE, McClay JL, McMahon FJ, Musil R, Saccone NL, Sangkuhl K, Stowe RM, Tan EC, Tiwari AK, Zai CC, Zai G, Zhang J, Gaedigk A, Müller DJ
- Issue date: 2021 Jan
- Does obtaining CYP2D6 and CYP2C19 pharmacogenetic testing predict antidepressant response or adverse drug reactions?
- Authors: Solomon HV, Cates KW, Li KJ
- Issue date: 2019 Jan
- Primary care and mental health providers' perceptions of implementation of pharmacogenetics testing for depression prescribing.
- Authors: Vest BM, Wray LO, Brady LA, Thase ME, Beehler GP, Chapman SR, Hull LE, Oslin DW
- Issue date: 2020 Oct 28