PI-023 - CHARACTERISTICS OF PROVIDERS WHO RESPONDED TO PASSIVE CLINICAL DECISION SUPPORT ALERTS FOLLOWING PRE-EMPTIVE RETURN OF PHARMACOGENOMIC RESULTS.

J. Martin, E. Shalowitz, D. Kao, K. Trinkley, C. Aquilante; University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

Background: Clinical decision support (CDS) is a key factor of preemptive pharmacogenomic (PGx) initiatives. Understanding who acts on PGx CDS alerts is crucial for intelligently designed, PGx-informed care. We evaluated characteristics of providers who made clinical actions in response to CDS alerts following a preemptive return of clinical PGx results.

Methods: We analyzed clinical actions resulting from PGx CDS alerts for CYP2C19 and SLCO1B1, totaling 17 drug-gene interactions (DGI). Medical specialty and provider type for whom alerts fired were captured. We used descriptive statistics for analysis.

Results: We evaluated 688 DGI alerts (98.3% passive) that fired for 592 patients. Of alert events, 66 (9.6%) led to a clinical action. Overall, 384 alerts (55.8%) fired for generalists of whom 38 (57.6%) took clinical action. However, specialists were more likely to make clinical actions for drugs relevant to their practice, except for PPIs (Table 1). Analyzing provider type, 253 alerts (36.8%) fired for physicians of whom 36 (54.5%) took clinical action, more than any other provider type.

Conclusion: Our results show that clinical actions associated with primarily passive PGx CDS alerts are most often made by physicians and specialists, rather than generalists. These data suggest that CDS tools can be further optimized for general providers, for whom alerts show frequently.

Table 1. Frequency Of Clinical Actions for a Given Provider Characteristic, By Drug Class