NDLI: Feasibility of implementing a comprehensive warfarin pharmacogenetics service.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Nutescu, Edith A. Drozda, Katarzyna Bress, Adam P. Galanter, William L. Stevenson, James Stamos, Thomas D. Desai, Ankit A. Duarte, Julio D. Gordeuk, Victor Peace, David Kadkol, Shrihari S. Dodge, Carol Saraf, Santosh Garofalo, John Krishnan, Jerry A. Garcia, Joe G. N. Cavallari, Larisa H.
Description	Country affiliation: Israel Author Affiliation: Nutescu EA ( Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL.)
Abstract	STUDY OBJECTIVE: To determine the procedural feasibility of a pharmacist-led interdisciplinary service for providing genotype-guided warfarin dosing for hospitalized patients newly starting warfarin. DESIGN: Prospective observational study. SETTING: A 438-bed tertiary care hospital affiliated with a large academic institution. PATIENTS: Eighty patients who started warfarin therapy and were managed by a newly implemented pharmacogenetics service. INTERVENTION: All patients received routine warfarin genotyping and clinical pharmacogenetics consultation. MEASUREMENTS AND MAIN RESULTS: The primary outcomes were percentage of genotype-guided dose recommendations available prior to the second warfarin dose and adherence of the medical staff to doses recommended by the pharmacogenetics service. Of 436 genotype orders placed during the first 6 months of the service, 190 (44%) were deemed appropriate. For the 80 patients on the service who consented to data collection, 76% of the genotypes were available prior to the second warfarin dose. The median (range) time from genotype order to genotype result was 26 hours (7-80 hrs), and the time to genotype-guided dose recommendation was 30 hours (7-80 hrs). A total of 73% of warfarin doses ordered by the medical staff were within 0.5 mg of the daily dose recommended by the pharmacogenetics consult service. CONCLUSION: Providing routine genotype-guided warfarin dosing supported by a pharmacogenetics consult service is feasible from a procedural standpoint, with most genotypes available prior to the second warfarin dose and good adherence to genotype-guided dose recommendations by the medical staff.
File Format	HTM / HTML
ISSN	02770008
e-ISSN	18759114
DOI	10.1002/phar.1329
Journal	Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Issue Number	11
Volume Number	33
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2013-11-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Pharmacology Medical Order Entry Systems Pharmacogenetics Pharmacy Service, Hospital Warfarin Adverse Effects Electronic Health Records Feasibility Studies Prospective Studies Therapeutic Use Observational Study
Content Type	Text
Resource Type	Article
Subject	Pharmacology (medical)

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