Implementation of pharmacogenetics: The University of Maryland personalized anti-platelet pharmacogenetics program

Alan R. Shuldiner; Kathleen Palmer; Ruth E. Pakyz; Tameka D. Alestock; Kristin A. Maloney; Courtney O'Neill; Shaun Bhatty; Jamie Schub; Casey Lynnette Overby; Richard B. Horenstein; Toni I. Pollin; Mark D. Kelemen; Amber L. Beitelshees; Shawn W. Robinson; Miriam G. Blitzer; Patrick F. Mcardle; Lawrence Brown; Linda Jo Bone Jeng; Richard Y. Zhao; Nicholas Ambulos; Mark R. Vesely

doi:10.1002/ajmg.c.31396

Implementation of pharmacogenetics: The University of Maryland personalized anti-platelet pharmacogenetics program

Alan R. Shuldiner, Kathleen Palmer, Ruth E. Pakyz, Tameka D. Alestock, Kristin A. Maloney, Courtney O'Neill, Shaun Bhatty, Jamie Schub, Casey Lynnette Overby, Richard B. Horenstein, Toni I. Pollin, Mark D. Kelemen, Amber L. Beitelshees, Shawn W. Robinson, Miriam G. Blitzer, Patrick F. Mcardle, Lawrence Brown, Linda Jo Bone Jeng, Richard Y. Zhao, Nicholas AmbulosMark R. Vesely

Research output: Contribution to journal › Article › peer-review

59 Scopus citations

Abstract

Despite a substantial evidence base, implementation of pharmacogenetics into routine patient care has been slow due to a number of non-trivial practical barriers. We implemented a Personalized Anti-platelet Pharmacogenetics Program (PAP3) for cardiac catheterization patients at the University of Maryland Medical Center and the Baltimore Veterans Administration Medical Center Patients' are offered CYP2C19 genetic testing, which is performed in our Clinical Laboratory Improvement Amendment (CLIA)-certified Translational Genomics Laboratory. Results are returned within 5hr along with clinical decision support that includes interpretation of results and prescribing recommendations for anti-platelet therapy based on the Clinical Pharmacogenetics Implementation Consortium guidelines. Now with a working template for PAP3, implementation of other drug-gene pairs is in process. Lessons learned as described in this article may prove useful to other medical centers as they implement pharmacogenetics into patient care, a critical step in the pathway to personalized and genomic medicine.

Original language	English (US)
Pages (from-to)	76-84
Number of pages	9
Journal	American Journal of Medical Genetics, Part C: Seminars in Medical Genetics
Volume	166
Issue number	1
DOIs	https://doi.org/10.1002/ajmg.c.31396
State	Published - Mar 2014
Externally published	Yes

Keywords

Anti-platelet pharmacogenetics
CYP2C19
Clopidogrel
Implementation science
Individualized medicine
Personalized medicine
Pharmacogenomics
Translational research

ASJC Scopus subject areas

Genetics
Genetics(clinical)

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Shuldiner, A. R., Palmer, K., Pakyz, R. E., Alestock, T. D., Maloney, K. A., O'Neill, C., Bhatty, S., Schub, J., Overby, C. L., Horenstein, R. B., Pollin, T. I., Kelemen, M. D., Beitelshees, A. L., Robinson, S. W., Blitzer, M. G., Mcardle, P. F., Brown, L., Jeng, L. J. B., Zhao, R. Y., ... Vesely, M. R. (2014). Implementation of pharmacogenetics: The University of Maryland personalized anti-platelet pharmacogenetics program. American Journal of Medical Genetics, Part C: Seminars in Medical Genetics, 166(1), 76-84. https://doi.org/10.1002/ajmg.c.31396

Shuldiner, AR, Palmer, K, Pakyz, RE, Alestock, TD, Maloney, KA, O'Neill, C, Bhatty, S, Schub, J, Overby, CL, Horenstein, RB, Pollin, TI, Kelemen, MD, Beitelshees, AL, Robinson, SW, Blitzer, MG, Mcardle, PF, Brown, L, Jeng, LJB, Zhao, RY, Ambulos, N & Vesely, MR 2014, 'Implementation of pharmacogenetics: The University of Maryland personalized anti-platelet pharmacogenetics program', American Journal of Medical Genetics, Part C: Seminars in Medical Genetics, vol. 166, no. 1, pp. 76-84. https://doi.org/10.1002/ajmg.c.31396

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abstract = "Despite a substantial evidence base, implementation of pharmacogenetics into routine patient care has been slow due to a number of non-trivial practical barriers. We implemented a Personalized Anti-platelet Pharmacogenetics Program (PAP3) for cardiac catheterization patients at the University of Maryland Medical Center and the Baltimore Veterans Administration Medical Center Patients' are offered CYP2C19 genetic testing, which is performed in our Clinical Laboratory Improvement Amendment (CLIA)-certified Translational Genomics Laboratory. Results are returned within 5hr along with clinical decision support that includes interpretation of results and prescribing recommendations for anti-platelet therapy based on the Clinical Pharmacogenetics Implementation Consortium guidelines. Now with a working template for PAP3, implementation of other drug-gene pairs is in process. Lessons learned as described in this article may prove useful to other medical centers as they implement pharmacogenetics into patient care, a critical step in the pathway to personalized and genomic medicine.",

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Implementation of pharmacogenetics: The University of Maryland personalized anti-platelet pharmacogenetics program

Abstract

Keywords

ASJC Scopus subject areas

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