PI-025 - DOCUMENTATION OF RESULTS AND MEDICATION PRESCRIBING AFTER COMBINATORIAL PSYCHIATRIC PHARMACOGENETIC TESTING.

J. Loftus, H. Levy, J. Stevenson; Johns Hopkins University, Baltimore, MD, USA.

Background: Combinatorial psychiatric pharmacogenetic (PGx) panels assay several genes and use this information in algorithms intended to improve prescribing. These tests do not directly interface with electronic health records (EHRs). We examined how results were documented and how often medications affected by the results were prescribed at an academic tertiary healthcare system.

Methods: We performed a text search of adult psychiatry service notes in our EHR using 81 PGx terms. Records containing terms were manually reviewed to determine if a combinatorial PGx panel was ordered and how results were documented. We examined prescription data after testing to determine how often medications affected by genes on the panel were prescribed.

Results: Of 412 tested patients, 42% had results documented for all tested genes, 30% had results for some genes, and 28% had no results documented in the EHR. Results were primarily documented as scanned media or in clinic note narratives. Of 228 patients with ≥1 year of follow-up, most received psychiatric and non-psychiatric medications affected by the results (Figure 1).

Conclusion: Results from combinatorial PGx tests were inconsistently documented in the EHR. Psychiatric and non-psychiatric medications affected by PGx were often prescribed after testing, highlighting a need for discrete results and clinical decision support.

Figure 1 – Percentage of patients initiating n medications affected by tested genes during follow-up