Real-world experience of using combinatorial pharmacogenomic test in children and adolescents with depression and anxiety
To evaluate the real-world impact of using a commercially available combinatorial pharmacogenomic (CPGx) test on medication management and clinical outcomes in children and adolescents treated at a tertiary care psychiatry practice. A retrospective cohort study using our prospectively maintained dat...
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| Veröffentlicht in: | Journal of psychiatric research 2022-02, Vol.146, p.83-86 |
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| creator | Dagar, Anjali Cherlopalle, Suneela Ahuja, Veena Senko, Lillian Butler, Robert S. Austerman, Joseph Anand, Amit Falcone, Tatiana |
| description | To evaluate the real-world impact of using a commercially available combinatorial pharmacogenomic (CPGx) test on medication management and clinical outcomes in children and adolescents treated at a tertiary care psychiatry practice.
A retrospective cohort study using our prospectively maintained database of patients undergoing CPGx testing was performed. Only patients with clinical data at the time of ordering CPGx test (pre-baseline), potential medication change visit (baseline) and 8-weeks follow-up (post-baseline) visit were included. Clinical Global Impression (CGI) scores for each visit were calculated. Appropriate statistical analysis, including one-sample t-test, paired t-test and Chi-square test was performed.
Based on the inclusion criteria, 281 (75.9%) of the 370 patients with CPGx testing were included. Their mean age was 15.8 ± 4.5 years (111 females; 39.5%). The average number of medications significantly increased to 2.4 ± 1.2 on the post-baseline visit [t(280) = 8.34, p |
| doi_str_mv | 10.1016/j.jpsychires.2021.12.037 |
| format | Article |
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A retrospective cohort study using our prospectively maintained database of patients undergoing CPGx testing was performed. Only patients with clinical data at the time of ordering CPGx test (pre-baseline), potential medication change visit (baseline) and 8-weeks follow-up (post-baseline) visit were included. Clinical Global Impression (CGI) scores for each visit were calculated. Appropriate statistical analysis, including one-sample t-test, paired t-test and Chi-square test was performed.
Based on the inclusion criteria, 281 (75.9%) of the 370 patients with CPGx testing were included. Their mean age was 15.8 ± 4.5 years (111 females; 39.5%). The average number of medications significantly increased to 2.4 ± 1.2 on the post-baseline visit [t(280) = 8.34, p < 0.001). Medications were added in 123 (43.7%), replaced in 92 (32.7%) patients and remained unchanged in rest. There was no significant association between medication-related adverse effects and psychotropic medication change group (p = 0.27). The study population showed a significant improvement (p < 0.001) in the CGI severity, efficacy, and global improvement indices.
In our experience of using CPGx test in a large cohort of children and adolescents during routine clinical practice, three-quarter of them underwent medication change. Additionally, we noted an improvement in clinical outcomes without impacting adverse effects. While the role of clinical judgement in medication changes in our cohort is likely, CPGx may supplement clinical decision making. However, the best use and benefit of CPGx in routine clinical practice needs further investigation.</description><identifier>ISSN: 0022-3956</identifier><identifier>EISSN: 1879-1379</identifier><identifier>DOI: 10.1016/j.jpsychires.2021.12.037</identifier><identifier>PMID: 34959162</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Adolescent,Psychiatric ; Adult ; Anxiety ; Child ; Depression ; Female ; Genesight ; Humans ; Mental illness ; Pharmacogenetics ; Pharmacogenomic Testing ; Pharmacogenomic,Child ; Retrospective Studies ; Young Adult</subject><ispartof>Journal of psychiatric research, 2022-02, Vol.146, p.83-86</ispartof><rights>2021 Elsevier Ltd</rights><rights>Copyright © 2021 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c374t-b9ff0451c754cc8e96a937a753227990fe0dcc3f246f9632a507bd8901b877213</citedby><cites>FETCH-LOGICAL-c374t-b9ff0451c754cc8e96a937a753227990fe0dcc3f246f9632a507bd8901b877213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022395621007391$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34959162$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dagar, Anjali</creatorcontrib><creatorcontrib>Cherlopalle, Suneela</creatorcontrib><creatorcontrib>Ahuja, Veena</creatorcontrib><creatorcontrib>Senko, Lillian</creatorcontrib><creatorcontrib>Butler, Robert S.</creatorcontrib><creatorcontrib>Austerman, Joseph</creatorcontrib><creatorcontrib>Anand, Amit</creatorcontrib><creatorcontrib>Falcone, Tatiana</creatorcontrib><title>Real-world experience of using combinatorial pharmacogenomic test in children and adolescents with depression and anxiety</title><title>Journal of psychiatric research</title><addtitle>J Psychiatr Res</addtitle><description>To evaluate the real-world impact of using a commercially available combinatorial pharmacogenomic (CPGx) test on medication management and clinical outcomes in children and adolescents treated at a tertiary care psychiatry practice.
A retrospective cohort study using our prospectively maintained database of patients undergoing CPGx testing was performed. Only patients with clinical data at the time of ordering CPGx test (pre-baseline), potential medication change visit (baseline) and 8-weeks follow-up (post-baseline) visit were included. Clinical Global Impression (CGI) scores for each visit were calculated. Appropriate statistical analysis, including one-sample t-test, paired t-test and Chi-square test was performed.
Based on the inclusion criteria, 281 (75.9%) of the 370 patients with CPGx testing were included. Their mean age was 15.8 ± 4.5 years (111 females; 39.5%). The average number of medications significantly increased to 2.4 ± 1.2 on the post-baseline visit [t(280) = 8.34, p < 0.001). Medications were added in 123 (43.7%), replaced in 92 (32.7%) patients and remained unchanged in rest. There was no significant association between medication-related adverse effects and psychotropic medication change group (p = 0.27). The study population showed a significant improvement (p < 0.001) in the CGI severity, efficacy, and global improvement indices.
In our experience of using CPGx test in a large cohort of children and adolescents during routine clinical practice, three-quarter of them underwent medication change. Additionally, we noted an improvement in clinical outcomes without impacting adverse effects. While the role of clinical judgement in medication changes in our cohort is likely, CPGx may supplement clinical decision making. However, the best use and benefit of CPGx in routine clinical practice needs further investigation.</description><subject>Adolescent</subject><subject>Adolescent,Psychiatric</subject><subject>Adult</subject><subject>Anxiety</subject><subject>Child</subject><subject>Depression</subject><subject>Female</subject><subject>Genesight</subject><subject>Humans</subject><subject>Mental illness</subject><subject>Pharmacogenetics</subject><subject>Pharmacogenomic Testing</subject><subject>Pharmacogenomic,Child</subject><subject>Retrospective Studies</subject><subject>Young Adult</subject><issn>0022-3956</issn><issn>1879-1379</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE9P3DAQxS1UBAv0KyAfe0nwnySOj-2q0EorVargbDn2hPUqsYOdLeTbY7pbeuQ0h3lv5r0fQpiSkhLa3OzK3ZQWs3URUskIoyVlJeHiBK1oK2RBuZCf0IoQxgou6-YcXaS0I4QIRqszdM4rWUvasBVafoMeiucQB4vhZYLowBvAocf75PwjNmHsnNdziE4PeNrqOGoTHsGH0Rk8Q5qx8zgnGWwEj7W3WNswQDLg54Sf3bzFFqacM7lw3PsXB_NyhU57PST4fJyX6OH2-_36R7H5dfdz_XVTGC6quehk35OqpkbUlTEtyEZLLrSoOWNCStIDscbwnlVNLxvOdE1EZ1tJaNeKXJdfoi-Hu1MMT_scWI0upxsG7SHsk2INrSkV2Zul7UFqYkgpQq-m6EYdF0WJegOvduo_ePUGXlGmMvhsvT5-2Xcj2HfjP9JZ8O0ggNz1j4OokvnL2uZbZlY2uI-_vAJAQ5w_</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Dagar, Anjali</creator><creator>Cherlopalle, Suneela</creator><creator>Ahuja, Veena</creator><creator>Senko, Lillian</creator><creator>Butler, Robert S.</creator><creator>Austerman, Joseph</creator><creator>Anand, Amit</creator><creator>Falcone, Tatiana</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202202</creationdate><title>Real-world experience of using combinatorial pharmacogenomic test in children and adolescents with depression and anxiety</title><author>Dagar, Anjali ; Cherlopalle, Suneela ; Ahuja, Veena ; Senko, Lillian ; Butler, Robert S. ; Austerman, Joseph ; Anand, Amit ; Falcone, Tatiana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c374t-b9ff0451c754cc8e96a937a753227990fe0dcc3f246f9632a507bd8901b877213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adolescent</topic><topic>Adolescent,Psychiatric</topic><topic>Adult</topic><topic>Anxiety</topic><topic>Child</topic><topic>Depression</topic><topic>Female</topic><topic>Genesight</topic><topic>Humans</topic><topic>Mental illness</topic><topic>Pharmacogenetics</topic><topic>Pharmacogenomic Testing</topic><topic>Pharmacogenomic,Child</topic><topic>Retrospective Studies</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dagar, Anjali</creatorcontrib><creatorcontrib>Cherlopalle, Suneela</creatorcontrib><creatorcontrib>Ahuja, Veena</creatorcontrib><creatorcontrib>Senko, Lillian</creatorcontrib><creatorcontrib>Butler, Robert S.</creatorcontrib><creatorcontrib>Austerman, Joseph</creatorcontrib><creatorcontrib>Anand, Amit</creatorcontrib><creatorcontrib>Falcone, Tatiana</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of psychiatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dagar, Anjali</au><au>Cherlopalle, Suneela</au><au>Ahuja, Veena</au><au>Senko, Lillian</au><au>Butler, Robert S.</au><au>Austerman, Joseph</au><au>Anand, Amit</au><au>Falcone, Tatiana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Real-world experience of using combinatorial pharmacogenomic test in children and adolescents with depression and anxiety</atitle><jtitle>Journal of psychiatric research</jtitle><addtitle>J Psychiatr Res</addtitle><date>2022-02</date><risdate>2022</risdate><volume>146</volume><spage>83</spage><epage>86</epage><pages>83-86</pages><issn>0022-3956</issn><eissn>1879-1379</eissn><abstract>To evaluate the real-world impact of using a commercially available combinatorial pharmacogenomic (CPGx) test on medication management and clinical outcomes in children and adolescents treated at a tertiary care psychiatry practice.
A retrospective cohort study using our prospectively maintained database of patients undergoing CPGx testing was performed. Only patients with clinical data at the time of ordering CPGx test (pre-baseline), potential medication change visit (baseline) and 8-weeks follow-up (post-baseline) visit were included. Clinical Global Impression (CGI) scores for each visit were calculated. Appropriate statistical analysis, including one-sample t-test, paired t-test and Chi-square test was performed.
Based on the inclusion criteria, 281 (75.9%) of the 370 patients with CPGx testing were included. Their mean age was 15.8 ± 4.5 years (111 females; 39.5%). The average number of medications significantly increased to 2.4 ± 1.2 on the post-baseline visit [t(280) = 8.34, p < 0.001). Medications were added in 123 (43.7%), replaced in 92 (32.7%) patients and remained unchanged in rest. There was no significant association between medication-related adverse effects and psychotropic medication change group (p = 0.27). The study population showed a significant improvement (p < 0.001) in the CGI severity, efficacy, and global improvement indices.
In our experience of using CPGx test in a large cohort of children and adolescents during routine clinical practice, three-quarter of them underwent medication change. Additionally, we noted an improvement in clinical outcomes without impacting adverse effects. While the role of clinical judgement in medication changes in our cohort is likely, CPGx may supplement clinical decision making. However, the best use and benefit of CPGx in routine clinical practice needs further investigation.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>34959162</pmid><doi>10.1016/j.jpsychires.2021.12.037</doi><tpages>4</tpages></addata></record> |
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| subjects | Adolescent Adolescent,Psychiatric Adult Anxiety Child Depression Female Genesight Humans Mental illness Pharmacogenetics Pharmacogenomic Testing Pharmacogenomic,Child Retrospective Studies Young Adult |
| title | Real-world experience of using combinatorial pharmacogenomic test in children and adolescents with depression and anxiety |
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