Estimating the potential impact of implementing pre‐emptive pharmacogenetic testing in primary care across the UK
British Journal of Clinical Pharmacology, vol. 87, pp. 2907–2925
Abstract
AIMS: Pharmacogenetics (PGx) in the UK is currently implemented in secondary care for a small group of high-risk medicines. However, most prescribing takes place in primary care, with a large group of medicines influenced by commonly occurring genetic variations. The goal of this study is to quantitatively estimate the volumes of medicines impacted by implementation of a population-level, pre-emptive pharmacogenetic screening programme for nine genes related to medicines frequently dispensed in primary care in 2019. METHODS: A large community pharmacy database was analysed to estimate the national incidence of first prescriptions for 56 PGx drugs used in the UK for the period 1 January-31 December 2019. These estimated prescription volumes were combined with phenotype frequency data to estimate the occurrence of actionable drug-gene interactions (DGI) in daily practice in community pharmacies. RESULTS: In between 19.1 and 21.1% (n = 5 233 353-5 780 595) of all new prescriptions for 56 drugs (n = 27 411 288 new prescriptions/year), an actionable drug-gene interaction (DGI) was present according to the guidelines of the Dutch Pharmacogenetics Working Group and/or the Clinical Pharmacogenetics Implementation Consortium. In these cases, the DGI would result in either increased monitoring, guarding against a maximum ceiling dose or an optional or immediate drug/dose change. An immediate dose adjustment or change in drug regimen accounted for 8.6-9.1% (n = 2 354 058-2 500 283) of these prescriptions. CONCLUSIONS: Actionable drug-gene interactions frequently occur in UK primary care, with a large opportunity to optimise prescribing.
Authors 5
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Essra Youssef corresponding
Affiliation as printed
School of Pharmacy University of East Anglia Norwich UK
School of Pharmacy, University of East Anglia, Norwich, UK
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Walgreens Boots Alliance (United Kingdom)
Affiliation as printed
Boots UK Thane Road, Nottingham UK
Boots UK, Thane Road, Nottingham, UK
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Affiliation as printed
School of Pharmacy University of East Anglia Norwich UK
School of Pharmacy, University of East Anglia, Norwich, UK
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Henk‐Jan Guchelaar Aachen Department of Clinical Pharmacy and Toxicology Leiden University Medical Center Leiden The Netherlands
Leiden University Medical Center
Affiliation as printed
Department of Clinical Pharmacy & Toxicology Leiden University Medical Center Leiden The Netherlands
Department of Clinical Pharmacy & Toxicology Leiden University Medical Center Leiden The Netherlands
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University of Nottingham · Walgreens Boots Alliance (United Kingdom)
Affiliation as printed
Boots UK Thane Road, Nottingham UK
School of Pharmacy University of Nottingham Nottingham UK
Boots UK, Thane Road, Nottingham, UK
School of Pharmacy, University of Nottingham, Nottingham, UK
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