Abstract
Introduction: Genetic testing in medical practice is becoming increasingly commonplace. Particularly relevant to geriatric medicine and polypharmacy is the science of pharmacogenetics; the testing of an individual patient to check for drug-gene interactions, which can determine if a new or existing prescription is a good fit for them. We wanted to establish the prevalence of prescriptions for medicines that have a known pharmacogenetic target in a population of people admitted to a geriatric medicine department at a UK teaching hospital.
Methods: We conducted a retrospective cohort analysis, using a year’s worth of electronic prescribing records (1/6/23 -31/05/24), for patients admitted under the care of any named geriatrician at a single site teaching hospital in the UK. We cross referenced those prescriptions against a reference list of pharmacogenetic medications (PGxMed) with a known applicable pharmacogenetic test.
Results: The department recorded 9115 admissions over this time period. Most patients received at least one PGxMed prescription, with nearly two thirds (61%, or 5528 out of 9115) of admissions in one year being associated with at least one PGx medication. 6 was the highest number of PGxMed prescriptions recorded against a single patient (3 instances). “Cholesterol lowering”, “Analgesic” and “Anticoagulant” were the top three classes of medication by frequency respectively.
Conclusions: Prescriptions for PGxMeds are highly prevalent in geriatric medicine in-patients, and more research is required to determine what the most cost-effective PGx testing approach is. There could be a role for PGx to help identify ineffective or harmful medication in this patient group. Given that geriatricians possess an acknowledged expertise in medication review, whilst PGx is still a nascent field of testing from a UK perspective, it is one for them to be aware of since it is likely to become of more relevance in clinical practice over the next few years.