A5063304095- Pharmacogenetics and Drug Metabolism
- Health Systems, Economic Evaluations, Quality of Life
- Pharmaceutical studies and practices
- Pharmaceutical Practices and Patient Outcomes
- BRCA gene mutations in cancer
- Health Policy Implementation Science
- Genomics and Rare Diseases
- Innovations in Medical Education
- Ethics in Clinical Research
- Antiplatelet Therapy and Cardiovascular Diseases
- Diabetes Management and Education
- Chronic Disease Management Strategies
- Cancer Genomics and Diagnostics
- Cultural Competency in Health Care
- Statistical Methods in Clinical Trials
- Cancer Treatment and Pharmacology
- Lipoproteins and Cardiovascular Health
- Health Literacy and Information Accessibility
- Pain Management and Opioid Use
- Treatment of Major Depression
- Cardiac electrophysiology and arrhythmias
- Health and Medical Research Impacts
- Medical Education and Admissions
- Innovative Teaching Methods
- Patient Safety and Medication Errors
North Dakota State University
2016-2025
Sanford Health
2019-2025
Dakota State University
2017-2025
Imagineering (Japan)
2024
American Association of Colleges of Pharmacy
2021
Ferris State University
2020
CYP2C19 genotype-guided antiplatelet therapy following percutaneous coronary intervention is increasingly implemented in clinical practice. However, challenges such as selecting a testing platform, communicating test results, building decision support processes, providing patient and provider education, integrating methods to the translation of emerging evidence practice are barriers broad adoption. In this report, we compare contrast implementation strategies 12 early adopters, describing...
The American Society of Health-System Pharmacists (ASHP) believes pharmacogenomic testing can improve medication-related outcomes across the continuum care in all health-system practice settings. These improvements include improved clinical outcomes, decreased side effects, lower cost treatment, increased medication adherence, more appropriate selection therapeutic agents, length and enhanced patient safety.1-4 Because their distinct knowledge, skills, abilities, pharmacists are uniquely...
The increased availability of clinical pharmacogenetic (PGx) guidelines and decreasing costs for genetic testing have slowly led to utilization PGx in practice. Pre-emptive testing, where is performed advance drug prescribing, one means ensure results are available at the time prescribing decisions. However, most efficient effective methods clinically implement this strategy remain unclear.In report, we compare contrast implementation strategies pre-emptive by 15 early-adopter institutions....
Genetic testing has the potential to revolutionize primary care, but few health systems have developed infrastructure support precision population medicine applications or attempted evaluate its impact on patient and provider outcomes. In 2018, Sanford Health, nation’s largest rural nonprofit care system, began offering genetic patients. To date, more than 11,000 patients participated in Chip Program, over 90% of whom been identified with at least one informative pharmacogenomic variant,...
The convergence of translational genomics and biomedical informatics has changed healthcare delivery. Institutional consortia have begun implementing lab testing decision support for drug–gene interactions. Aggregate datasets are now revealing the impact clinical Given pleiotropic nature pharmacogenes, interdisciplinary teams robust tools must exist within an framework built to be flexible capable cross-talk between specialties. Navigation challenges presented with implementation five steps...
To determine how US and Canadian pharmacy schools include content related to health disparities cultural competence literacy in curriculum as well review assessment practices.
Genomics is becoming an increasingly important part of health care, and pharmacists are well-positioned to be practice-based leaders in pharmacogenomics precision medicine. Competencies available through the Genetics/Genomics Competency Center provide a framework for instruction both pharmacy school curricula continuing education programs. Given significant advancements over past decade, 2019-2020 American Association Colleges Pharmacy Pharmacogenomics Special Interest Group updated...
Metoprolol is a medication commonly utilized in select patients to achieve reduction heart rate, systolic blood pressure, or other indications. A majority of metoprolol metabolism occurs via CYP2D6. Decreased expression the CYP2D6 enzyme increases concentration metoprolol. Current pharmacogenomics guidelines by Dutch Pharmacogenomics Working Group recommend slower titrations and dose decreases minimize adverse effects from poor metabolizers normal taking concomitant medications that are...
Genetic variants can impact medication response. The study of genetic on medications is called pharmacogenomics (PGx). Understanding PGx results be difficult as are reported differently than other laboratory tests. Patients have a lack understanding and satisfaction with information. Surveys were emailed to patients seen in the clinic who participated an elective screening (Sanford Chip) at Sanford Health. conducted assess literacy, testing. Survey responses summarized using descriptive...
Purpose Evidence-based guidelines recommend regular depression screening among individuals with type 2 diabetes mellitus (T2DM). The purpose of this study is to examine patterns a primary care population T2DM, through use the Patient Health Questionnaire-9 (PHQ-9). Methods In total, 1817 patients T2DM were analyzed retrospective observational at sites, regional health center and federally qualified (FQHC). sample was divided into those without major depressive disorder (MDD) diagnosis....
Abstract There is growing interest in utilizing pharmacogenetic (PGx) testing to guide antidepressant use, but there lack of clarity on how implement into clinical practice. We administered two surveys at 17 sites that had implemented or were the process implementing PGx for antidepressants. Survey 1 collected data and logistics testing. 2 asked rank importance Consolidated Framework Implementation Research (CFIR) constructs using best‐worst scaling choice experiments. Of sites, 13 four...
Abstract Purpose We describe the implementation and ongoing maintenance of CYP2C19 CYP2D6 focused pharmacogenetic (PGx) testing to guide antidepressant antianxiety medication prescriptions in a large rural, nonprofit health system. Summary Depression anxiety are common psychiatric conditions. Sanford Health implemented PGx for metabolism cytochrome P450 (CYP) isozymes 2C19 2D6 2014 inform prescribing multiple medications, including therapies. As guidelines, genotype phenotype translation,...
Background: Statins are commonly used medications. Variants in SLCO1B1, CYP2C9, and ABCG2 known predictors of muscle effects when taking statins. More exploratory genes include RYR1 CACNA1S, which can also be associated with disease conditions. Methods: Patients pathogenic/likely pathogenic variants or CACNA1S were identified through an elective genomic testing program. Through chart review, patients a history statin use assessed for statin-associated symptoms (SAMS) along collection...
Abstract Pharmacogenetic testing could reduce the time to identify a safe and effective medication for depression; however, it is underutilized in practice. Major depression constitutes most common mental disorder US, while antidepressant therapy can help, current trial –and error approach require patients endure multiple trials before finding one that effective. Tailoring fit of pharmacogenetic with prescribers' needs across variety settings help establish generalizable value proposition...
This paper describes one healthcare system's approach to strategically deploying genetic specialists and pharmacists support the implementation of a precision medicine program. In 2013, Sanford Health initiated development system-wide Here, we report necessary staffing including counselors, counseling assistants, pharmacists, geneticists. We examined administrative electronic medical records data summarize referrals over time as well uptake results an enterprise-wide screening test. Between...
Despite the increased demand for pharmacogenetic (PGx) testing to guide antidepressant use, little is known about how implement in clinical practice. Best-worst scaling (BWS) a stated preferences technique determining relative importance of alternative scenarios and increasingly being used as healthcare assessment tool, with potential applications implementation research. We conducted BWS experiment evaluate factors PGx use.We surveyed 17 organizations that either had implemented or were...
Background: Returning pharmacogenomics (PGx) results to patients is complex and challenging. Patients prefer provider education; however, a gap in comfort PGx has been documented. Objectives: This study's purpose was evaluate satisfaction with the return of test using patient portal message. Methods: A survey sent two cohorts results, one that received result message did not. Results: Following implementation message, there decrease reporting negative responses surrounding their 39%...
As genomic medicine becomes increasingly complex, pharmacists need to work collaboratively with other healthcare professionals provide genomics-based care. The core pharmacist competencies in genomics were recently updated and mapped the entrustable professional activities (EPAs). new competency that is "Interprofessional Team Member" EPA domain emphasizes role of as pharmacogenomics experts an interprofessional team. Interprofessional education (IPE) involving student students from...
Abstract Purpose To compare rates of prescriber acceptance interruptive and noninterruptive clinical decision support (CDS) alerts regarding potential diminished therapeutic effectiveness safety risks associated with proton pump inhibitor (PPI) use in carriers gene variants affecting cytochrome P450 (CYP) isozyme 2C19 metabolism. Methods A retrospective study was conducted at a large rural health system to examine different approaches improving CDS alert while minimizing fatigue. Manual...