To understand the clinical utility of multi-gene pharmacogenetic testing in patients receiving palliative and supportive care across palliative care settings (inpatient hospital, outpatient), specifically to calculate a drug-gene interaction ratio, based on extant prescriptions paired with an individual's pharmacogenetic results.
This is a prospective, observational cross-sectional study of patients with serious and/or life limiting condition conditions, such as incurable cancer undergoing palliative or supportive care treatment at a University Teaching Hospital in England, UK. Participants will be recruited at point of referral to in-patient or outpatient palliative care services (i.e. at point of presentation with symptom control issues). All participant study activities: All participants will undergo testing of a panel of genetic variants relevant to drugs used in symptom control (see https://cpicpgx.org/genes-drugs/ ). This will involve collecting a 5mL blood sample (the intervention) from individuals. All participants will be consented to examination of their records within local hospitals and/or primary care to extract study relevant data (described below). The start of follow-up will be from the date of the blood sample (the intervention). Standard demographic information including ethnicity will be collected at baseline. Participation in study will be for the duration of being under palliative care treatment, up to a maximum of 90days from recruitment date. All participant sample will be stored and genetic analysis will take place after the end of recruitment and health data collection. The study team will then calculate a drug-gene interaction ratio (DGI) (i.e. The total number of genetic variation results that pair with a relevant prescribed medication for that same individual, divided by total number of individuals tested).
Study Type
OBSERVATIONAL
Enrollment
50
Norfolk and Norwich University Hospitals NHS Foundation Trust
Norwich, Norfolk, United Kingdom
The Manchester Centre for Genomic Medicine
Manchester, United Kingdom
Drug-gene interaction ratio (DGI)
The total number of genetic variation results that pair with a relevant prescribed medication for that same individual, divided by total number of individuals tested.
Time frame: This will be calculated for all current medications prescribed at the point of recruitment.
Frequency of changes in prescription medication that are potentially affected by drug-gene interaction
Number of participants who have a change in prescribed medication (dose or formulation) during 90 day follow up period that could be theoretically paired to possession of a clinically relevant drug-gene interaction
Time frame: from enrolment until 90 days post blood test
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