The primary goal of this study is to conduct pharmacogenomics testing (a type of DNA test) within an aging population and measure the impact of this test on medication selection, dosing, healthcare utilization, and costs of care.
Pharmacogenomics is the study of how a patient's unique DNA may interact with medications that the patient currently takes or may take in the future. DNA may change how a patient reacts to a medication, such as changing how well it works or the side effects. Knowing a patient's DNA profile may help healthcare professionals select the best medication treatment plan to use. This could include selecting the best medication to give or the medication strength that will work best for the patient. Currently, there is no standard that helps healthcare professionals decide to order a pharmacogenomics test that includes multiple genes. The investigators of this study think that having these DNA results in the medical record for participants who are at least 65 years old and are taking 5 or more medications will result in better health since healthcare professionals may use these results for treatment planning. Knowing if this is true will help healthcare professionals decide if ordering this test will improve patient health. This study seeks to recruit participants for a pharmacogenomic study who visit at Geisinger 65 Forward locations. Patients who meet the study requirements and consent to be enrolled in this study will be randomly put into a group that receives this pharmacogenomics test or a group that does not receive it. There is a 50% chance of being put in the group that receives this pharmacogenomics test. The investigators will follow all patients enrolled in this study as they visit with their healthcare providers in the future. Geisinger healthcare professionals will have access to the results of this test in the medical record.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
NONE
Enrollment
2,000
This multigene pharmacogenomics test will report genetic variation for genes that have Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines.
Geisinger
Danville, Pennsylvania, United States
Number of pharmacogenomic results returned in patients' health records
The primary objective will be assessed by comparing the total number of patients with returned results in the electronic health record (EHR) with the total number of tested patients.
Time frame: Date of blood draw to test results reported in medical record, up to 1 month
Composite of changes to medication therapy
The number of medication changes (e.g. dose or agent change) that healthcare professionals initiate due to pharmacogenomics return of results.
Time frame: Date of test results reported to end of study, up to 5 years
Number of hospitalizations
The number of hospitalizations patients encounter after receiving pharmacogenomics results
Time frame: Date of test results reported to end of study, up to 5 years
Number of ambulatory visits
The number of outpatient clinic visits patients encounter.
Time frame: Date of test results reported to end of study, up to 5 years
Costs of clinical care
The total healthcare costs of patients.
Time frame: Date of test results reported to end of study, up to 5 years
Medical costs of care
Measure of the costs of medical care (e.g. hospitalizations, outpatient visits, etc.), excluding pharmacy services.
Time frame: Date of test results reported to end of study, up to 5 years
Pharmacy costs of care
Measure of the costs of all pharmacy services (e.g. medications, consults, etc.).
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Time frame: Date of test results reported to end of study, up to 5 years