The purpose of this study is to evaluate the impact of genetic testing on healthcare decisions and patient outcomes for patients suffering from pain, cardiovascular problems, Arthritis, Type II Diabetes, and/or Mental Health disorders. Results of genetic testing will also be compared with the clinical outcome measures collected to discover novel genetic factors that may influence patient care.
The molecular basis of many pharmacogenetic polymorphisms has now been elucidated, with genetic variations resulting in alteration of expression or function of receptors, enzymes, and transporters relevant to the safety and efficacy of a medical treatment. Genetics has been shown to be a significant factor in the variability of responses of medication choices and doses. With the rapid development of cost-effective high throughput molecular genotyping methods, pharmacogenetics has become increasingly important because of its potential to identify patients with increased risk of adverse drug reactions or decreased likelihood of response at standard dosage of drug. By identifying the genetic risks and the most effective therapy for an individual patient, clinicians may improve the efficacy of treatment and decrease the risk of adverse drug events. The addition of pharmacogenetic testing to routine clinical practice may also be extremely helpful because of the cost reduction associated with the identification of patients that will not respond to expensive drugs or with the identification of patients likely to suffer from severe adverse events. There are also tremendous efforts in the pharmaceutical industry to lower the cost for drug development; pharmacogenetics may fulfill the need to provide the right drug to the right patient and to increase the likelihood of success of large phase II and phase III clinical trials. The purpose of this study is to evaluate how currently available genetic tests are being implemented in various clinics around the United States, and whether this information results in benefits to patient care. Patients presenting to clinics with pain, cardiovascular conditions, Arthritis, Type II Diabetes, and/or Mental Health disorders that are receiving Proove Bioscience's genetic testing will complete validated questionnaires to measure specific outcomes related to their treatment at each clinical visit, including medication efficacy, reduction in adverse drug events, and healthcare utilization. Physicians will document any changes made to treatment regimens, including adjustments to medications or non-pharmacological treatments, and any improvements in the outcome measures. Statistical analysis will be performed to calculate relationships between genotypic and phenotypic data points collected in this study. The results of this study will provide a measurable understanding of the medical and economic value of implementing genetic testing into clinical care. Furthermore, data points collected will be used to examine novel correlations and associations between single nucleotide polymorphisms and longitudinal clinical outcome measures.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
100,000
The physicians of this group of patients will be unblinded to the results of the genetic testing.
The physicians of this group of patients will be blinded to the results of the genetic testing. They will be un-blinded to the results of each patient once that patient has completed the study.
Medical Clinic - Amy Weinberg M.D. Inc
Beverly Hills, California, United States
Medical Clinic - Dr. Neil Ghodadra
Beverly Hills, California, United States
Snibbe Orthopedics
Beverly Hills, California, United States
Robert Graham, MD
Fresno, California, United States
Bautista Medical Group
Fresno, California, United States
Pain Scores on the Pain Numeric Rating Scale (NRS)
Time frame: 60 days
Function/Disability assessment on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
Time frame: 60 days
Number of Participants that Experience of Adverse Events
Time frame: Up to 2 years
Type of Adverse Events Experienced by Participants
Time frame: Up to 2 years
Severity of Adverse Events Experienced by Participants
Time frame: Up to 2 years
Type of medication or alternative therapy prescribed for participants, as listed on the Medication Efficacy Differentiation (MED) Scale or on the investigator's evaluation form
Time frame: Up to 2 years
Medication dosage prescribed to the participants
Time frame: Up to 2 years
Frequency of participant urine drug screens
Time frame: Up to 2 years
Self-rated response levels to prescribed medications
Subjects are ask to rate the ability of their medication, on a scale of 0 to 5, to treat their condition and/or relieve their symptoms.
Time frame: 60 days
Presence and Severity of Generalized Anxiety Disorder on the GAD-2
Time frame: 60 days
Presence and Severity of Depression on the PHQ-2
Time frame: 60 days
Presence of atrial fibrillation symptoms and their impact on quality of life using the Severity of Atrial Fibrillation (SAF) scale
Time frame: 60 days
Risk of cardiovascular incidents using the AHA Heart Disease Risk Assessment
Time frame: 60 days
Risk of stroke using the CHA2DS2-VASc Score
Time frame: 60 days
Severity of Rheumatoid Arthritis using the Routine Assessment of Patient Index Data (RAPID-3) score
Time frame: 60 days
BMI for patients being treated for T2DM
Time frame: 60 days
Glucose levels for patients being treated for T2DM
Time frame: 60 days
Co-occurring disorders collected by ICD-9/10 codes
Time frame: 60 days
Assessment of previous treatments
Participants are asked to rate the benefit of previous treatments on a scale of 0 to 5.
Time frame: 60 days
Urine drug screen results
Time frame: 60 days
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Torrey Pines Orthopaedic Medical Group
La Jolla, California, United States
Soha Dolatabadi Rheumatology
Los Angeles, California, United States
Summit Family Medicine
Murrieta, California, United States
Macer Medical
Rolling Hills, California, United States
Medical Clinic - Paul C. Murphy, MD Inc
San Diego, California, United States
...and 21 more locations