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. 2020 Dec;30(9):201-207.
doi: 10.1097/FPC.0000000000000414.

Methods and implementation of a pediatric asthma pharmacogenomic study in the emergency department setting

Jennifer N Fishe  1 , Rebecca K Higley  1 , Deirdre Casey  2 , Lamont Hogans  2 , Todd W Wylie  1 , Phyllis L Hendry  1 , Morgan Henson  1 , Andrew Bertrand  1 , Kathryn V Blake  3
Affiliations

Methods and implementation of a pediatric asthma pharmacogenomic study in the emergency department setting

Jennifer N Fishe et al. Pharmacogenet Genomics. 2020 Dec.

Abstract

Objectives: The emergency department (ED) is a challenging setting to conduct pharmacogenomic studies and integrate that data into fast-paced and potentially life-saving treatment decisions. Therefore, our objective is to present the methods and feasibility of a pilot pharmacogenomic study set in the ED that measured pediatric bronchodilator response (BDR) during acute asthma exacerbations.

Methods: This is an exploratory pilot study that collected buccal swabs for DNA and measured BDR during ED encounters for pediatric asthma exacerbations. We evaluated the study's feasibility with a qualitative analysis of ED provider surveys and quantitatively by the proportion of eligible patients enrolled.

Results: We enrolled 59 out of 90 patients (65%) that were identified and considered eligible during a 5-month period (target enrollment 60 patients over 12 months). The median patient age was 7 years (interquartile range 4-9 years), 61% (N = 36) were male, and 92% (N = 54) were African American. Quality DNA collection was successful for all 59 patients. The ED provider survey response rate was 100%. Most ED providers reported that the study did not impact their workflow (98% of physicians, 88% of nurses, and 90% of respiratory therapists). ED providers did report difficulties with spirometry in the younger age group.

Conclusions: Pharmacogenomic studies can be conducted in the ED setting, and enroll a younger patient population with a high proportion of minority participants. By disseminating this study's methods and feasibility analysis, we aim to increase interest in pharmacogenomic studies set in the ED and aimed toward future ED-based pharmacogenomic decision-making.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1:
Figure 1:
Frontline Emergency Department Provider Survey Responses regarding Study Impact on Workflow
Figure 2:
Figure 2:
Word Cloud of Free Text Comments in Front-line Staff Surveys Delayed treatment (N=5), Distracted Patient/Parent (N=2), Machine did not work (N=2), Patient unable to complete (N=2), Patient was in distress (N=2), Too young (N=2), Not Cooperating (N=1), Not Needed (N=1), Parent Refused (N=1), Easy (N=1)
See this image and copyright information in PMC

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