Implementation of Standardized Clinical Processes for TPMT Testing in a Diverse Multidisciplinary Population: Challenges and Lessons Learned

• DOI: 10.1111/cts.12533
• Publication Date: 2018-01-19T21:02:38Z
• Authors: Kristin W. Weitzel; D. Max Smith; Amanda R. Elsey; Benjamin Q. Duong; Benjamin Burkley; Michael Clare‐Sal...; Yan Gong; Tara A. Higgins; Benjamin Kong; Taimour Langaee; Caitrin W. McDonough; Benjamin J. Staley; Teresa T. Vo; Dyson T. Wake; Larisa H. Cavallari; Julie A. Johnson
• Keywords: Thiopurine methyltransferase; Pediatric cancer

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 ordered for gastroenterology, rheumatology, dermatology, hematology/oncology (661 of (79.2%); 580 outpatient vs. 293 inpatient; P < 0.0001). Thirty‐nine had both genotype enzyme n = 2 discordant results). observed significant differences between test use characteristics multispecialty environment setting, which led unique needs. As pharmacogenetic implementations expand, disseminating lessons learned real‐world environments will be important support routine adoption.