Providers’ use of pharmacogenetic testing to inform opioid prescribing among veterans
Creators: name: Lipsky, Rachele K
name: Chanfreau-Coffinier, Catherine
name: Voora, Deepak
name: Trafton, Jodie
name: Williams, Charlotte
name: Martins, Susana B
name: Muralidhar, Sumitra
name: Oslin, David W
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Medicine
subject: Pharmacology
subject: Sociology
subject: FOS: Sociology
subject: Science Policy

description: <b>Aim:</b> To survey Veterans Health Administration providers who prescribed tramadol or codeine to patients with known genotyping for cytochrome 2D6 (<i>CYP2D6</i>) to ascertain awareness of their patient’s pharmacogenetic (PGx) test status, whether these results influenced prescribing, perceived benefit of PGx testing, and resources needed to obtain and deliver PGx testing information. <b>Materials &amp; methods:</b> A provider survey was conducted of those who prescribed tramadol or codeine in a patient genotyped for <i>CYP2D6</i>. <b>Results:</b> Of 876 eligible providers, 220 completed the survey. Ten percent were aware that their patient received a PGx test, 64% had not ordered any PGx test related to any medication in the prior year, 55% strongly agreed or agreed that PGx testing is or will be valuable to guide pain medication prescriptions, 29% felt that the evidence base for PGx testing is very strong or moderately strong, 22% responded likely or extremely likely to order a future PGx test, and 51% felt that it would be either very important or fairly important to have a local subject matter expert as a resource for PGx testing. <b>Conclusion:</b> There are modifiable factors that the Veterans Health Administration could address to optimize PGx testing for pain management. There are gaps in the knowledge, attitude, and behaviors surrounding pharmacogenetic (PGx) testing among healthcare providers who prescribe opioids in the Veterans Health Administration. The study surveyed providers who had prescribed tramadol or codeine in a patient known to have been genotyped for <i>CYP2D6</i> in order to ascertain: provider awareness of their patient's PGx test status; whether PGx test results influenced prescribing practices, or demonstrated the perceived benefit of PGx testing and the methods that providers would like see in order to be made aware of PGx test results, and what resources they would need to incorporate PGx test results into clinical practice. The majority (64%) of surveyed providers had never ordered a PGx test before, a little over half (55%) of the providers felt that PGx testing for pain management is valuable, but only 22% of the cohort would feel likely or extremely likely to order a PGx test in the future. Overall, providers felt that a local subject matter expert who would support clinicians’ use of PGx testing would be the best way to deliver PGx testing information to them, and that print material for patients that provide an explanation of PGx testing would be the best way to deliver PGx testing information to patients. There are modifiable factors that could be addressed by the Veterans Health Administration in order to optimize PGx testing for pain management.