Feasibility of clinical pharmacist-led CYP2C19 genotyping for patients receiving non-emergent cardiac catheterization in an integrated health system
Pharm. pract. (Granada, Internet)
; 15(2): 0-0, abr.-jun. 2017. tab, ilus, graf
Article
in English
| IBECS
| ID: ibc-164244
Responsible library:
ES1.1
Localization: BNCS
ABSTRACT
Objective:
To assess the feasibility of clinical pharmacist-led CYP2C19 genotype-guided P2Y12 inhibitor antiplatelet drug therapy recommendations to cardiologists in an outpatient cardiology practice.Methods:
This was a prospective, open-labeled, single-arm study conducted in an integrated healthcare delivery system between March 1, 2013 and January 23, 2014. Patients requiring non-emergent cardiac catheterization were included. A clinical pharmacist provided interpretation and recommendations from genotyping results. The feasibility of implementing CYP2C19 genotype-guided antiplatelet therapy was assessed by the 1) percentage of patients approached who consented to CYP2C19 genotyping, 2) percentage of patients with CYP2C19 genotyping results available prior to cardiac catheterization, and 3) percentage of clinical pharmacist CYP2C19 genotype-based antiplatelet recommendations accepted by cardiologists.Results:
Of the 43 patients identified for potential recruitment, 22 of these were eligible for study enrollment and 6 (27%) patients consented and received CYP2C19 genotyping. All patients had genotyping results available prior to catheterization and all clinical pharmacists antiplatelet therapy recommendations were accepted by the patients cardiologists. Three patients had the CYP2C19 wild-type (*1/*1) genotype and the clinical pharmacist recommended clopidogrel therapy. CYP2C19 variant genotypes (i.e., *1/*2, *1/*17, and *2/*17) were found in the other three patients; alternative antiplatelet therapy was recommended for the patient with the *1/*2 genotype, while clopidogrel was recommended for those with *1/*17 and *2/*17 genotypes.Conclusion:
A relatively small proportion of patients undergoing non-emergent cardiac catheterization consented to pharmacogenetic testing; however, their cardiologists were receptive to clinical pharmacists conducting such testing and providing corresponding pharmacotherapy recommendations. Future studies should identify patient barriers to pharmacogenetic testing (AU)RESUMEN
No disponible
Full text:
Available
Collection:
National databases
/
Spain
Database:
IBECS
Main subject:
Platelet Aggregation Inhibitors
/
Acute Coronary Syndrome
/
Cytochrome P-450 CYP2C19
/
Cytochrome P-450 CYP2C19 Inducers
Type of study:
Practice guideline
/
Observational study
Aspects:
Implementation research
Limits:
Humans
Language:
English
Journal:
Pharm. pract. (Granada, Internet)
Year:
2017
Document type:
Article
Institution/Affiliation country:
American College of Clinical Pharmacy/United States
/
Kaiser Permanente Colorado/United States
/
Providence Medical Group/United States
/
University of Colorado Skaggs/United States
/
Walgreens/United States