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Review
. 2016 Jul;100(1):63-6.
doi: 10.1002/cpt.347. Epub 2016 Mar 31.

Implementation of a Pharmacogenomics Consult Service to Support the INGENIOUS Trial

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Free PMC article
Review

Implementation of a Pharmacogenomics Consult Service to Support the INGENIOUS Trial

M T Eadon et al. Clin Pharmacol Ther. .
Free PMC article

Abstract

Hospital systems increasingly utilize pharmacogenomic testing to inform clinical prescribing. Successful implementation efforts have been modeled at many academic centers. In contrast, this report provides insights into the formation of a pharmacogenomics consultation service at a safety-net hospital, which predominantly serves low-income, uninsured, and vulnerable populations. The report describes the INdiana GENomics Implementation: an Opportunity for the UnderServed (INGENIOUS) trial and addresses concerns of adjudication, credentialing, and funding.

Figures

Figure 1
Figure 1
The interface between the INGENIOUS trial and the pharmacogenomics consult service. Any Eskenazi prescriber may enroll her or his patient following an incident new prescription of one of the 28 drugs. Patients are randomized to the standard care control arm (no genotyping) or the intervention arm (genotyping). Patients randomized to the genotyping arm are consented for enrollment by a research assistant, and DNA is collected. The genotyping core laboratory provides all pharmacogenomic results and recommendations to the EMR, enrolling physician, and the adjudication committee. The adjudication committee reviews the genotype for incidental findings and notifies an appropriate physician of actionable genotypes. Eskenazi prescribers may choose to follow recommendations or not. They may also choose to request a consult if they require additional information or support. Consults are derived from provider referrals.

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