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 journalArticlepeer-review

59 Scopus citations


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 languageEnglish (US)
Pages (from-to)76-84
Number of pages9
JournalAmerican Journal of Medical Genetics, Part C: Seminars in Medical Genetics
Issue number1
StatePublished - Mar 2014
Externally publishedYes


  • 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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