Category: Fellows Posters
Purpose: Patients who receive clopidogrel and are CYP2C19 no-function allele carriers have higher rates of major adverse cardiovascular events when compared to non-carriers. ASHP-endorsed guidelines recommend these receive alternative therapy after percutaneous coronary intervention. Due to the lifelong value of these data and potential risk of misuse (inappropriately changing medications on their own), patient education is an important aspect of patient-centered care. At UPMC Presbyterian, a pharmacist-led pharmacogenomics (PGx) service has provided CYP2C19 genotyping and clinical recommendations (n >2700) since 2015. However, the value pharmacists may add when counseling patients and its impact on patient-centered outcomes is unknown.
Methods: In an IRB-approved, prospective, single-site study, patients will be randomized to one of two education methods following PGx testing. Either an educational pamphlet or the pamphlet with additional in-person pharmacist counseling will be provided to participants. Patients will be surveyed via telephone at 7 days and 30 days post-PCI to assess the importance of the intervention on patient-centered outcomes. These surveys will assess the following domains: 1) PGx understanding, 2) satisfaction with counseling, 3) data sharing with downstream providers, 4) antiplatelet medication outcomes, and 5) medication adherence. The primary outcome will be patient understanding. All survey questions will be coded and scored at the individual question level. Median scores for ordinal questions will be calculated for each group. Odds ratios and chi square tests will be calculated to compare groups. A sample of 50 patients (randomized 1:1) will provide 80% power to detect an effect size of 0.4 in the patient understanding survey item (“why was your DNA tested?”). Statistical analyses will be conducted in R. This study design will demonstrate how pharmacist educational counseling impacts patient-centered outcomes in patients receiving pharmacogenetic testing.