Pharmacogenetic Testing and Clinical Decision Support Tools Improve Quality of Life, Reduce Costs
Pharmacogenetic testing supported by clinical decision support tools significantly reduce hospital readmissions and emergency room visits, resulting in health resource savings and improved healthcare, according to a study published in PLOS One (published online February 2, 2017; doi: 10.1371/journal.pone.0170905).
Patients ages 50 years or older often take multiple medications and experience poor compliance because of adverse drug events, which result in increased emergency department visits, re-hospitalizations, and decreased quality of life. In polypharmacy patients under home health management, pharmacogenetic testing along with guidance from a clinical decision support tool on reducing drug, gene, and cumulative interaction risk could offer valuable insights in prescription drug treatment, reducing re-hospitalizations, and emergency department visits.
Lindsay S Elliott, MD, department of pharmacy practice, Harding University (Searcy, AR), and colleagues conducted a study to assess how clinical support decision tools ability to reduce re-hospitalizations and emergency department visits when assisting pharmacogenetic testing for polypharmacy patients ages 50 years or older recently discharged from the hospital. A total of 110 patients from a hospital-based home health agency between 2015 and 2016 were randomized to pharmacogenetic profiling (n = 57)—in which drug-drug, drug-gene, and cumulative drug or gene interactions were reviewed using a clinical decision support tool—or a control group (n = 53) that received treatment as usual. The primary outcome was number of re-hospitalizations and emergency department visits at 30 and 60 days after discharge from the hospital.
Results of the study showed the mean number of re-hospitalizations per patient in the tested vs control group was 0.25 vs 0.38 at 30 days and 0.33 vs 0.70 at 60 days, respectively. At 30 days, the mean number of emergency department visits per patient was 0.25 in the tested group, compared with 0.40 in the control group. At 60 days, the mean number of emergency department visits per patients was 0.39 in the tested group, compared with 0.66 in the control group.
Researchers concluded that the combination of pharmacogenetics testing and clinical decision support tools significantly reduces hospital readmissions and emergency department up to 60 days following hospital discharge for polypharmacy patients ages 50 years or older. Implications of this finding include potential health resource utilization savings and long-term improved healthcare, which attract attention from policymakers as a way to improve quality of care and reduce costs.