A5015655047- Pharmacogenetics and Drug Metabolism
- Pharmaceutical studies and practices
- Health Systems, Economic Evaluations, Quality of Life
- Statistical Methods in Clinical Trials
- Pain Management and Opioid Use
- Colorectal Cancer Treatments and Studies
- BRCA gene mutations in cancer
- Neutropenia and Cancer Infections
- Antiplatelet Therapy and Cardiovascular Diseases
- Cancer Treatment and Pharmacology
- Pharmacological Effects and Toxicity Studies
- Neurological disorders and treatments
- Health and Medical Research Impacts
- Biochemical and Molecular Research
- Drug Transport and Resistance Mechanisms
- Pharmaceutical Economics and Policy
- Health Policy Implementation Science
- Opioid Use Disorder Treatment
- Meta-analysis and systematic reviews
- Ethics in Clinical Research
- Parkinson's Disease Mechanisms and Treatments
- Agricultural Productivity and Crop Improvement
- Social Media in Health Education
- Agriculture, Plant Science, Crop Management
- Healthcare professionals’ stress and burnout
Georgetown University Medical Center
2020-2025
Georgetown University
2019-2025
MedStar Health
2019-2025
University of Florida
2017-2024
University of Michigan–Ann Arbor
2024
University of Colorado Anschutz Medical Campus
2024
Levine Cancer Institute
2024
American College of Clinical Pharmacy
2021
Florida College
2012-2020
University of Florida Health
2018
Abstract Pharmacologic treatment for essential tremor and the of Parkinson's disease is often inadequate. Stereotaxic surgery, such as thalamotomy, can effectively reduce tremors. We performed a multicenter trial unilateral high‐frequency stimulation ventral intermedius nucleus thalamus in 29 patients with 24 disease, using blinded assessment at 3 months after surgery to compare clinical rating ON OFF baseline 1‐year follow‐up. Six were not implanted because lack intraoperative suppression...
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....
In 2018, a patient received capecitabine without prior testing for dihydropyrimidine dehydrogenase (DPYD) and later presented with vomiting, rash, diarrhea.The hospital failed to provide uridine triacetate in timely fashion, the died.The patient's widow filed wrongful death lawsuit against Oregon Health Sciences University (OHSU) assisted formation of nonprofit organization advocate DPYD fluoropyrimidines.A settlement $1 million US dollars was reached requiring OHSU oncologists undergo...
Abstract Background The CYP2C19 nonfunctional genotype reduces clopidogrel effectiveness after percutaneous coronary intervention (PCI). Following clinical implementation of genotyping at University Florida (UF) Health Shands Hospital in 2012, where results are available approximately 3 days PCI, testing was expanded to UF Jacksonville 2016 utilizing a rapid approach. We describe metrics with this latter implementation. Methods Patients undergoing left heart catheterization intent undergo...
Huddart, Rachel; Hicks, J. Kevin; Ramsey, Laura B.; Strawn, Jeffrey R.; Smith, D. Max; Bobonis Babilonia, Margarita; Altman, Russ Klein, Teri E.Author Information
The safety of systemic fluoropyrimidines (e.g., 5-fluorouracil, capecitabine) is impacted by germline genetic variants in DPYD, which encodes the dihydropyrimidine dehydrogenase (DPD) enzyme that functions as rate-limiting step catabolism this drug class. Genetic testing to identify those with DPD deficiency can help mitigate risk severe and life-threatening fluoropyrimidine-induced toxicities. Globally, integration DPYD into patient care has varied greatly, ranging from being required...
This trial aimed to identify the effects of providing pharmacogenomic (PGx) results and recommendations for patients with chronic pain treated in primary care practices compared standard care. An open-label, prospective, largely virtual, type-2 hybrid effectiveness randomized participants PGx or arms. Adults ≥ 3 months who were tramadol, codeine, hydrocodone enrolled. Alternative analgesics recommended CYP2D6 intermediate poor metabolizers (IM/PMs). Prescribing decisions at providers'...
Abstract Although thiopurine S‐methyltransferase ( TPMT ) genotyping to guide dosing is common in the pediatric cancer population, limited data exist on testing implementation diverse, multidisciplinary settings. We established (genotype and enzyme) with clinical decision support, provider/patient education, pharmacist consultations a tertiary medical center collected over 3 years. During this time, 834 patients underwent 873 tests (147 (17%) genotype, 726 (83%) enzyme). were most commonly...
Pharmacogenetic testing (PGT) is increasingly being used as a tool to guide clinical decisions. This article describes the development of an outpatient, pharmacist-led, pharmacogenetics consult clinic within internal medicine, its workflow, and early results, along with successes challenges. A pharmacogenetics-trained pharmacist encouraged primary care physicians (PCPs) refer patients who were experiencing side effects/ineffectiveness from certain antidepressants, opioids, and/or proton pump...
Aims: Identify the attitudes and interests of primary care providers (PCPs) in applying clinical pharmacogenomics (PGx) test results. Materials & methods: A questionnaire was designed then disseminated to PCPs across MedStar Health System. Results: Ninety 312 (29%) responded were included analyses. Seventy-six (84%) had heard PGx 12 (13%) previously ordered testing. Most, 68 (76%), believed can improve care; however, a minority, 23 (26%), reported confidence using prescribing decisions....
There is growing experience translating genomic data into clinical practice, as seen with the Implementing GeNomics In pracTicE (IGNITE) network. A primary example influence of CYP2D6 genotype on beneficial and adverse effects some opioids. Clinical recommendations exist to guide drug therapy based for codeine, tramadol, oxycodone hydrocodone, although level supporting evidence differs by drug. Limited also supports use genetic other medications in chronic pain therapy, including tricyclic...
Most literature describing pharmacogenetic implementations are within academic medical centers and use single-gene tests. Our objective was to describe the results lessons learned from a multisite pilot that utilized panel-based testing in nonacademic settings. This retrospective analysis of 667 patients 4 perioperative 5 outpatient cardiology clinics. Recommendations related 12 genes 65 drugs were classified as actionable or not actionable. They ascertained Clinical Pharmacogenetics...
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...
Pharmacogenetics can improve clinical outcomes by reducing adverse drug effects and enhancing therapeutic efficacy for commonly used drugs that treat a wide range of cardiovascular diseases. One the major barriers to implementation pharmacogenetics is limited education on this field current healthcare providers students. The abundance pharmacogenetic literature underscores its promise, but it also be challenging learn such wealth information. Moreover, recommendations confusing because they...