On Friday’s we will post new and relevant information regarding Pharmacogenetics. We hope you will find this useful and pass along to colleagues. If you should have any questions or would like to request education or schedule a webinar regarding pharmacogenetics, please feel free to reach out to us at PGx Medical, info@pgxmed.com or 405-509-5112.
How is pharmacogenetics affecting the efficacy of medical treatment?
Pharmacogenomics can help doctors pick the right treatment option and dose for each patient. photo source: nigms.nih.gov
Your genes determine your hair and eye color, they also play a key role in how medications work in your body.
Currently, providers base the majority of their drug prescriptions on factors, such as a patient’s age, weight, sex, and liver and kidney function. Researchers have identified genetic variations that influence how people respond. When using a pharmacogenetic test result, providers can use this information to select the best medication and identify people who need an unusually high or low dose.
Pharmacogenetics looks at variations in genes for proteins that influence drug responses. These proteins include a number of liver enzymes that convert medications into their active or inactive forms. Even small differences in the genetic sequences of these enzymes can have a big impact on a drug’s safety or effectiveness.
Anticoagulants are one of the most frequently prescribed medications in elderly patients.
Polypharmacy is a growing concern in the elderly population
Some common cardiovascular disorders in older adults have a relationship to thrombosis, including ischemic heart disease, atrial fibrillation, valvular disease, and atherosclerotic vascular disease.
Thrombophilia (sometimes hyper coagulability or a prothrombotic state) is an abnormality of blood coagulation that increases the risk of thrombosis (blood clots in blood vessels). Such abnormalities can be identified in 50% of people who have an episode of thrombosis (such as deep vein thrombosis in the leg) that was not provoked by other causes.
Older adults represent a patient population at high thromboembolic risk, but also at high hemorrhagic risk. Physicians have a tendency to underuse anticoagulants in the elderly, most likely because of underestimation of thromboembolic risk and overestimation of bleeding risk.
Despite the stroke risk being much higher in the elderly population, the presence of associated comorbidities and accompanying polypharmacy leads to physicians’ being less eager to initiate anticoagulation therapy in the elderly, despite the greater absolute stroke risk reduction by doing so.
Another consideration in deciding on anticoagulation therapy is the elderly patients’ propensity to fall. According to the U.S. Centers for Disease Control and Prevention, every 11 seconds an older adult is treated in the emergency room for a fall; every 19 minutes, an older adult dies from a fall.
One of the most compelling examples of potential benefits from pharmacogenetic testing is warfarin. Warfarin is a widely prescribed oral anticoagulant; for decades it has been used as standard drug to prevent and treat thrombotic events in patients with deep vein thrombosis, various hypercoagulable states, atrial fibrillation, surgical cardiac valve replacement, etc.
One of the major problems with its use in clinical practice is large inter-individual variation – patients differ in sensitivity to warfarin, hence the dose requirements vary widely (up to 20-fold). The consequences of over- or under-anticoagulation can be serious. In patients less sensitive than typical, the standard doses may be too low to achieve anticoagulation and therapeutic failure may occur, while in highly sensitive individuals the same doses may lead to serious adverse effects, such as hemorrhage.
PGx Medical is the trusted and experienced resource for the implementation of pharmacogenetics into the field of aging services. We work with LTC communities, clinics and pharmacies across the country educating and implementing pharmacogenetics into their day-to-day patient care.
For more information on education opportunities or implementing pharmacogenetics, contact:
In 2015, the American Geriatrics Society (AGS) updated the Beers Criteria list of potentially inappropriate medications to be monitored or avoided when treating older adults.
The goal of the Beers Criteria is to improve the care of older adults by reducing their exposure to potentially inappropriate medications (PIMs). This is accomplished by using the criteria as an educational tool and quality measure. According to the AGS, two uses that are not always in agreement.
Prescribing decisions are not always clear-cut, and clinicians must consider multiple factors, including discontinuation of medications no longer indicated.
The AGS Beers Criteria for PIM use in older adults is one of the most frequently consulted sources about the safety of prescribing medications for older adults and is used widely in geriatric clinical care, education, and research and in development of quality indicators.
The Beers list is important to help with deprescribing medications that are unnecessary, which helps to reduce the problems of polypharmacy, drug interactions, and adverse drug reactions, improving the risk–benefit ratio of medication regimens in older at-risk adults.
Pharmacogenetics is a tool being used in LTC communities, clinics and pharmacies across the country to help with proper prescribing in older adults. The PGx Medical test results highlight medications on the Beers report making it easy for providers to quickly determine which medications might be inappropriate for each individual person.
For more information on pharmacogenetics, contact:
PGx Medical
info@pgxmed.com
405-509-5112.
Doctors are using pharmacogenomics to help determine what drugs will work, and which drugs to avoid.
not new, but more and more doctors are testing their patients to see how they process a variety of drugs from pain relievers to cardio medications. This will tell them who the medication will work for, who it won’t, and who might have a severe drug reaction and avoid that.
Doctors keep the genetic information on file so they can check to see if a drug will work or cause a problem before prescribing it. This helps take the guesswork out of prescriptions.
Pharmacogenomics not only helps with medications patients are currently taking, but will guide their future prescriptions and potentially save lives.
PGx Medical is the trusted and experienced resource for the implementation of pharmacogenetics into the field of aging services.
For more information, contact:
PGx Medical info@pgxmed.com
405-509-5112
The Institute of Medicine defines patient–centered care as: “Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.”
Education is key to Patient-Centered Care
In 2016, there were approximately 4.45 billion prescriptions issued all over the United States. And according to the Patient-Centered Primary Care Collaborative, four out of five patients who visit a physician leave with at least one prescription.
Medications are involved in 80 percent of all treatments and impact every aspect of a patient’s life. The two most commonly identified drug therapy problems in patients receiving comprehensive medication management services are: (1) The patient requires additional drug therapy for prevention, synergistic, or palliative care; and (2) The drug dosages need to be titrated to achieve therapeutic levels that reach the intended therapy goals.
Drug therapy problems occur every day and add substantial costs to the health care system. Drug-related morbidity and mortality was estimated to cost $76.6 billion in the ambulatory setting in the United States. The largest component of this total cost was associated with drug-related hospitalizations.
So what can we do as a society to help focus on Patient-Centered Care and decrease the cost related to drug therapy? Educate.
By educating healthcare professionals on the tools and resources available will help not only individualize care, but will also save money and time by providing scientific based results for proper prescribing and help eliminate the “trial & error” prescribing that has been done for decades.
When a patient is on medications he/she can metabolize properly, you reduce the risk of falls, re-hospitalization and what they call the “Prescribing Cascade” where the side effects of drugs are misdiagnosed as symptoms of another problem resulting in further prescriptions and further side effects and unanticipated drug interactions.
So how do we combat this problem? Pharmacogenetic testing.
Pharmacogenetics is one of those tools. Pharmacogenetics aligns current and future medications with each persons unique genetic profile. It is a simple cheek swab that can help “personalize” medicine based on each individual person – Right Drug, Right Dose, for the Right Person.
Patient-centered care is intended to empower patients in making decisions regarding their own healthcare. The hope is by engaging patients and getting input on their own health, they will have better outcomes. Education is a big component of patient-centered care. By educating the patient and providing information to help them understand their diagnosis and treatment, they can begin to work alongside their provider and have input into their treatment.
Patients bring a unique perspective on their own care. No one knows your body better then you. Far too often patients and their families are not educated or informed on their healthcare decisions. Looking forward into the future, creating a system that is “patient-centered” and focuses on educating patients and healthcare providers will help in so many areas of our healthcare system.
PGx Medical is single-focused. Meaning, we do one thing and we do it with passion. We focus on pharmacogenetics in the field of aging services. As consultants, PGx Medical educates healthcare providers, senior communities, patients and families across the country on the benefits and value of this medication management tool.
For more information, or to schedule an educational webinar or request educational material, contact:
PGx Medical
405-509-5112
info@pgxmed.com
Pharmacogenetics can play an important role in effective use of medications by optimizing drug dose, identifying responders and non-responders to medications, and avoiding adverse events by aligning medications with personal DNA.
Learn how to effectively implement a pharmacogenetics program into your community to help improve quality of life, quality of care, reduce medication costs, and optimize medication usage.
To request more information, or to schedule a webinar or phone call, contact PGx Medical at info@pgxmed.com or 405-509-5112.
The goal of the Beers Criteria is to improve the care of older adults by reducing their exposure to potentially inappropriate medications (PIMs). This is accomplished by using the criteria as an educational tool and quality measure. According to the AGS, two uses that are not always in agreement.
