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Pharmacogenomics a good match

Pharmacogenomics a good match

SEPTEMBER 2016 – A Canadian team of researchers won the top research prize at the 2016 World Congress of Pharmacy and Pharmaceutical Sciences conference in Buenos Aires, Argentina, hosted by the International Pharmaceutical Federation, for its study on personalized medicine in community practice. 

John Papastergiou, owner of two Shoppers Drug Mart pharmacies in Toronto and Adjunct Assistant Professor at the faculties of pharmacy at University of Toronto and University of Waterloo, spearheaded the research after partnering with GenYouIn Inc., manufacturer of the PillCheck screening system. The system provides an analysis of patients’ drug metabolic profiles, and how their bodies respond to a list of specified medications. From there, pharmacists can recommend changes, if required, to optimize outcomes.

The Innovative Canadian Pharmacogenomic Screening Initiative in Community Pharmacy (ICANPIC) study recruited 100 patients at Papastergiou’s two pharmacies. Participating pharmacists received 60 hours of training. After performing a medication review as part of Ontario’s MedsCheck program, the pharmacist conducts a buccal swab to collect the patient’s DNA. Results initially go to the pharmacist, who meets with the patient a second time to interpret the findings and recommend changes to therapy, if required. Highlights of the study include:

  • Participating patients were taking 5.6 chronic medications on average; their average age was 57.4 years.
  • The most common reasons for pharmacogenomics testing were ineffective therapy (44.6%), adverse reactions (35.5%) and initiation of therapy (11.8%).
  • Pharmacists identified an average of 1.3 drug therapy problems per patient.
  • Pharmacists’ recommendations included changes to therapy (57.1%), increased monitoring (19.6%), dose adjustments (14.3%) and discontinuations of therapy (7.1%).

At the Ontario Pharmacists Association’s conference in June, Papastergiou presented case studies based on actual screenings. For example, a female patient suffering from a “chronic” H. pylori infection was found to be an “ultrafast metabolizer” of pantoprazole, which resulted in the discontinuation of that drug and the initiation of new therapy. In another case, a patient with anxiety stopped taking paroxetine due to side effects, but experienced little benefit from using escitalopram instead. Pharmacogenomic testing revealed that, based on her metabolic profile, this patient would benefit from a lower dose of paroxetine or a higher dose of escitalopram.

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