by brant bullard | Jun 4, 2015 | News
Average clinical outcomes determine FDA-approved dosages
Approved drug dosages may not be suitable for all patients, since they are often based on population-based efficacy and safety outcomes from clinical trials.
It is estimated that prescribed dosages are appropriate for only 40% of patients – those who are extensive (normal) metabolizers.
One size DOES NOT fit all.
* Based on phenotyoe distributionfor the CYP2C19 isoenzyme for clopidogrel
For more information on pharmacogenetic testing, contact:
PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112
by brant bullard | May 27, 2015 | News
Studies show approximately a third of community-dwelling people aged 65 years and older fall at least once per year.
According to National Center for Biotechnology Information, falls are the leading cause of injuries among older adults, aged 65 years and older. Numerous studies have identified risk factors and investigated possible strategies to prevent (recurrent) falls in community-dwelling older people and those living in long-term care facilities. Several types of drugs have been associated with an increased fall risk. Since drugs are a modifiable risk factor, periodic drug review among older adults should be incorporated in a fall prevention program.
Several types of drugs are associated with a significant risk of falls, the so-called ‘fall risk increasing drugs’. Falls and the use of psychotropic, cardiac and analgesic drugs in the older population. Antidepressants have long been recognized as a contributory factor to falls. Fall risk increases with the number of drugs used per day and polypharmacy (the use of at least three drugs) is regarded as an important risk factor for falls in older people. A recent cross-sectional study showed that polypharmacy itself is not a risk factor for falling, unless a fall risk increasing drug is part of the drug regimen.
Although fall incidents are the main mechanism for injuries, underlying medical conditions, such as osteoporosis, places older individuals at higher risk of injurious falls. The prevention of falls is a first and important step, but should be accompanied by optimizing the patient’s condition and medication use to reduced injuries due to falls.
Falls are a major public health problem in ageing populations worldwide. Fall-related injuries have large societal and individual consequences. Programmes to prevent falls and fractures should be implemented to reduce the associated injury, mortality, costs and substantial burden on healthcare workers and institutions.
Drug prescriptions for older patients require close attention, particularly since drug metabolism, efficacy and ADRs vary significantly between older and younger individuals.
The total healthcare costs spent on falls are high, partly due to the high incidence of falls, but also because of the high costs per incident. Besides the large burden of healthcare consumption and costs, falls may have a major impact on the individual patient.
Pharmacogenomic testing can be a tool to help guide healthcare professionals when prescribing to older adults to help prevent drug-on-drug interactions or falls due to medication adherance.
Preventing or limiting falls can lower healthcare costs and keep your patients living longer…better!
For more information on Metabolic Validation, via pharmacogenomic testing, contact:
PGx Medical
Individualized Care – Personalized Medicine
405-509-5112
info@pgxmed.com
Source: ncbi.com
by brant bullard | May 21, 2015 | News
A Pharmacy Consultant Case Study on the Utilization of Metabolic Validation
Garrett Huxall, Pharm.D, CGP, FASCP
Executive Director, PharmCareOK
As a pharmacy consultant and nursing home owner, understanding medications and their side effects is critical to my patient care. I have been utilizing a metabolic validation program that allows me to recommend proper medication therapy more quickly and accurately. The tool from PGx Medical replaces the “trial and error” process consultants cannot afford in a nursing home setting.
I have countless success stories due to the metabolic validation report, however, what I am finding is the small changes make the biggest impact. I now adjust dosages based on the resident/patient’s metabolic report. Furthermore, I now select medications that can be properly metabolized, where in the past I would have just gone to the next drug and hoped for a better outcome.
Case Study #3 – [Male LTC resident]. This patient was only on allopurinol and was then prescribed Lipitor and had a reaction. They thought his reaction was more of a psychotic reaction so they prescribed him Geodon. The patient had a severe reaction and tried to strangle his father. He was then admitted to a Psych Hospital and we decided to do a pharmacogenomic test to determine if his body could even metabolize the medications. By the enzymes we found, the Geodon or any of the new atypical drugs weren’t going to work for him. Se we put him on thorazine and got him calmed down – then we started reducing the thorazine. Now the patient is back on allopurinol for gout and that is the only prescription medication he is taking. Great outcome!
Previously, without the testing results to guide us, this change may have taken several different methods and a longer time frame to achieve results. It was very reassuring and validating to me that we were able to intervene with this resident on a much quicker basis and help her avoid falls, which is a benefit to the clinical team and the medical director.
In this case, the small change with guidance from the test results allowed for a rapid intervention that may have taken months. The small changes can have tremendous benefits to all parties involved. The test results came back in a matter of a day or two and we were able to save thousands of future Medicare dollars as a result of avoiding possible injuries due to her falls.
Educating the clinical team and medical directors at the facility on the value this tool provides is crucial, as it is 100% covered by Medicare. It’s important to reassure residents and family members that the medications they are taking are the most appropriate and able to provide proper therapy. A less medicated, cognizant, mobile resident allows for the home to be more efficient and profitable.
For more information on the metabolic validation program, info@pgxmed.com or 405-509-5112
by brant bullard | May 20, 2015 | News
At PGx Medical, our goal is to educate healthcare professionals across the country on our Metabolic Validation Program, via pharmacogenomic testing. Also known as personalized medicine.
The term “personalized medicine” is often described as providing “the right drug, the right dose, to the right person.” More broadly, personalized medicine (also known as precision medicine) may be thought of as the tailoring of medication therapy to the individual during day-to-day patient care.
Personalized medicine can eliminate the “trial & error” process and help healthcare professionals more accurately treat patients based on their individual make-up.
Why the push back?
While the majority of healthcare professionals understand pharmacogenomics and how to use the tool to guide them when treating patients. While many more still do not understand the tool and the benefit it brings to not only the patient, but the healthcare staff and family caring for the patient. Thats where PGx Medical President, Clay Bullard understands the need for more education.
Bullard travels around the country speaking to groups and organizations on the value the test can bring. Clay’s passion for the test shows when he asks providers, “if this was your loved one, would you want to know if their medication is working properly? You don’t know, what you don’t know. And our simple buccal swab of the cheek will tell you if your loved one is even capable of metabolizing their medications. And the best part is, it’s 100% reimbursed by Medicare B.”
PGx Medical works with many clinics, pharmacies, LTC/AL communities, hospice and home health companies across the contry.
“It’s all about education,” said Bullard. Once they understand it, it becomes part of their everyday patient care.”
For more information on the PGx Medical Metabolic Validation Program, contact:
info@pgxmed.com
405-509-5112
www.pgxmed.com
by brant bullard | May 20, 2015 | Metabolic Validation Program
A Pharmacy Consultant Case Study on the Utilization of Metabolic Validation
Garrett Huxall, Pharm.D, CGP, FASCP
Executive Director, PharmCareOK
As a pharmacy consultant with over 20 years of experience and now nursing home owner, I understand that medications and their side effects can critically impact a patients’ care. To aid physicians in their management and choice of medications for various disease states, I have been utilizing a metabolic validation program that allows me to recommend proper medication therapy more quickly and accurately. The tool from PGx Medical replaces the “trial and error” process consultants cannot afford in a nursing home setting.
I have numerous stories on how a metabolic validation report impacted my dosage recommendation or regimen changes. However, small adjustments in dosage or selection of a new pharmaceutical agent with guidance from the Metabolic Validation report, have lead me to now select medications that can be properly metabolized. Where in the past, I would have just gone to the next drug and hoped for a better outcome.
Below is the second in a series of case studies I have written:
Case Study #2 – [Male patient, multiple med, pain regimen not providing therapy] This patient was on Loritab, asprin and an NSAID for several months. Patient continued to complain of strong pain and medication dosages were increased with no effectiveness in pain reduction. Upon requesting a metabolic validation diagnostic, patients was placed on Dilaudid . Once we reviewed the test results, we were able to lower his dose of Dilaudid, twice daily while continuing with Asprin. Before the test he was taking loratab, asprin and an NSAID. We reduced the patients’ pain medications by 50% and he is doing much better.
In reducing the medications by 50% we are also helping to eliminate many of the complications often associated with heavy dosages and large regimens of pain medications. And reduce the cost of treatment to Medicare for this patient.
Previously, without the testing results to guide us, this change may have taken several different methods and a longer time frame to achieve results. It was very reassuring and validating to me that we were able to intervene with this resident on a much quicker basis and help him avoid falls, which is a benefit to the clinical team and the medical director.
Educating the clinical team and medical directors at the facility on the value this tool provides is crucial, as it is 100% covered by Medicare. It’s important to reassure residents and family members that the medications they are taking are the most appropriate and able to provide proper therapy. A less medicated, cognizant, mobile resident allows for the home to be more efficient and profitable.
For more information on the metabolic validation program, info@pgxmed.com or 405-509-5112
