The purpose of this study is to determine the clinical and economic effectiveness of a pharmacogenomic (PGx) approach to prescribing medications in patients with high-risk polypharmacy in an integrated healthcare delivery system. Investigators hypothesize that patients who receive the RightMed® PGx test from OneOme, LLC with subsequent counseling of their prescribers by a study pharmacist, as needed, on the appropriateness of their prescribed medications will experience lower one-year follow-up healthcare utilization and expenditures compared to control patients who receive usual care.
The purpose of this study is to determine the clinical and economic effectiveness of a pharmacogenomic (PGx) approach to prescribing medications in patients with high-risk polypharmacy in an integrated healthcare delivery system. Investigators hypothesize that patients who receive the RightMed® PGx test from OneOme, LLC with subsequent counseling of their prescribers by a study pharmacist, as needed, on the appropriateness of their prescribed medications will experience lower one-year follow-up healthcare utilization and expenditures compared to control patients who receive usual care. Primary Objectives: 1. Healthcare expenditures: 6- and 12-month changes in total healthcare expenditures from the Kaiser Permanente Colorado (KPCO) perspective 2. Healthcare utilization: 6- and 12-month changes in hospitalizations, emergency room visits, medical office visits, and telephone encounters Secondary Objectives: 1. Medication changes: Counts of 6-month medication and/or dose adjustments in targeted medications 2. Medication congruence: Description of counts of RightMed test recommendations accepted by prescribers 3. Medication adherence: 6- and 12-month changes in percent of days (PDC) covered for targeted medications 4. Pharmacy expenditures: 6- and 12-month changes in outpatient prescription medication expenditures from the KPCO perspective
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
600
The RightMed test is an end-to-end solution which includes sample collection, PGx testing services, data analysis, and clinical interpretation that helps prescribers select treatments based on evidence-driven predictions of patient drug response and tolerance. Genetic components of an individual's drug response are well established and often included on FDA medication labels. The RightMed test has incorporated existing evidence to classify the risk and likelihood of an antidepressant working for different patients. Patient results for each medication can fall into one of three categories: 1) Green - use as directed; 2) Yellow - use with caution; and 3) Red - adjust dose or choose alternative mediation.
Central Support Services
Aurora, Colorado, United States
Healthcare expenditures
Changes in mean/median total healthcare expenditures from the KPCO perspective
Time frame: 6 and 12 months after consent
Healthcare utilization
Changes in the proportion with at least one and mean/median count of hospitalization, emergency room visit, medical office visit, and telephone encounter
Time frame: 6 and 12 months after consent
Medication changes
Mean/median counts of medication and/or dose adjustments in targeted medications
Time frame: 6 months after consent
Medication congruence
Description of counts of RightMed test recommendations accepted by prescribers
Time frame: 6 months after consent
Medication adherence
Mean/median changes in percent of days (PDC) covered for targeted medications
Time frame: 6 and 12 months after consent
Pharmacy expenditures
Mean/median changes in outpatient prescription medication expenditures from the KPCO perspective
Time frame: 6 and 12 months after consent
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