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. 2021 May 11;11(5):394.
doi: 10.3390/jpm11050394.

Implementing Pharmacogenomics Testing: Single Center Experience at Arkansas Children's Hospital

Pritmohinder S Gill  1   2 , Feliciano B Yu  3 , Patricia A Porter-Gill  2 , Bobby L Boyanton  4 , Judy C Allen  5 , Jason E Farrar  1   2   6 , Aravindhan Veerapandiyan  2   7 , Parthak Prodhan  2   8 , Kevin J Bielamowicz  1   2   6 , Elizabeth Sellars  1   2   9 , Andrew Burrow  1   2   9 , Joshua L Kennedy  1   2 , Jeffery L Clothier  10 , David L Becton  1   2   6 , Don Rule  11 , G Bradley Schaefer  1   2   12
Affiliations

Implementing Pharmacogenomics Testing: Single Center Experience at Arkansas Children's Hospital

Pritmohinder S Gill et al. J Pers Med. .

Abstract

Pharmacogenomics (PGx) is a growing field within precision medicine. Testing can help predict adverse events and sub-therapeutic response risks of certain medications. To date, the US FDA lists over 280 drugs which provide biomarker-based dosing guidance for adults and children. At Arkansas Children's Hospital (ACH), a clinical PGx laboratory-based test was developed and implemented to provide guidance on 66 pediatric medications for genotype-guided dosing. This PGx test consists of 174 single nucleotide polymorphisms (SNPs) targeting 23 clinically actionable PGx genes or gene variants. Individual genotypes are processed to provide per-gene discrete results in star-allele and phenotype format. These results are then integrated into EPIC- EHR. Genomic indicators built into EPIC-EHR provide the source for clinical decision support (CDS) for clinicians, providing genotype-guided dosing.

Keywords: best practice alerts (BPAs); clinical decision support (CDS); electronic health records (EHR); genomic indicators; genotype; pediatrics; pharmacogenomics (PGx); phenotype.

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Conflict of interest statement

D.R. is primary shareholder in Translational Software, Inc. (TSI). All other authors reported no conflict of interest.

Figures

Figure 1
Figure 1
Pharmacogenomics and drug response in individuals with different genotypes.
Figure 2
Figure 2
Placing an order for PGx test in ACH EPIC (A,B).
Figure 3
Figure 3
Implementation of pharmacogenomic workflow at ACH. The clinician can order the PGx test in EPIC; genomic indicators in EPIC were built with respective clinical decision supports (CDS). Physicians can receive discrete laboratory results, comprehensive PGx report, and BPAs.
Figure 4
Figure 4
Best practice alerts (BPAs) for high risk PGx actionable genotypes with clinical decision support (CDS) for clinicians in EPIC (EPIC © 2021 Epic Systems Corporation): (A) clopidogrel, (B) mercaptopurine and (C) phenytoin.
Figure 4
Figure 4
Best practice alerts (BPAs) for high risk PGx actionable genotypes with clinical decision support (CDS) for clinicians in EPIC (EPIC © 2021 Epic Systems Corporation): (A) clopidogrel, (B) mercaptopurine and (C) phenytoin.
See this image and copyright information in PMC

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