UF Health study to assess pharmacogenetic testing in the ER

GAINESVILLE, Fla. — A team of University of Florida Health researchers spanning the Gainesville and Jacksonville campuses launched a five-year research project measuring the feasibility, cost-effectiveness, and net benefits of implementing precision medicine strategies like pharmacogenetic testing in the emergency room.

Led by investigators Julio Duarte, Pharm.D., Ph.D., an associate professor of pharmacotherapy and translational research in the UF College of Pharmacy, and Sophia Sheikh, M.D., an associate professor of emergency medicine at the UF College of Medicine – Jacksonville, the project, which received a $3.4 million grant from the National Institutes of Health, aims to identify patient populations for whom precision medicine techniques may improve clinical outcomes and reduce health care costs.

Sheikh cited the growing trend of repeat emergency room visits as the impetus for this work, which seeks to determine the common causes leading patients to return to the ER for issues related to a disease or its associated medications. The team hypothesizes that using pharmacogenetic testing, which analyzes how a patient’s genetic makeup influences their responses to medications, will lead to a decrease in ER return visits, health care costs, medication ineffectiveness, and the side effects patients may experience.

“We’re looking at a number of potential drug interactions that could impact a person’s reasons for coming back to the emergency department. Maybe they’re not achieving the results they should be with a particular medication. Could there be a genetic reason for why they’re not able to metabolize a certain medication?” Sheikh said. “This may be just one piece of the puzzle, but I think it’s an important piece that hasn't really been delved into.”

Duarte said the research project has three components: expanding pharmacogenetic testing resources for clinicians, determining the feasibility and effectiveness of implementing the testing for high-risk patients frequently visiting the ER, and assessing the cost-effectiveness and benefits associated with the testing.

“First, we will continue to build the computer-based decision support we already have within the electronic health records at UF Health, which will alert clinicians when patients may be at an increased risk of side effects from a medication. For patients needing to receive care outside of UF Health, we are providing a card containing a QR code, which clinicians can scan to view personalized drug recommendations for that patient,” Duarte said. “The second component is a randomized clinical trial of patients with and without pharmacogenetic testing that will determine if the testing is truly reducing emergency department visits. Finally, a cost-effectiveness analysis will show us the potential economic value of this precision medicine approach.”

Duarte said the data this project gathers will inform future clinical implementation efforts and larger, multi-site clinical trials, ultimately leading to a better understanding of the benefits of personalized drug therapy and other precision medicine techniques in the ER.

“Precision medicine provides clinicians with valuable information to individualize prescribing and patient care strategies. The thought is that we’ll get better results; happier, healthier patients; and hopefully, it’ll be more efficient and cost less,” he said.

Sheikh said this multidisciplinary research spanning two UF Health campuses serves as a powerful example of the positive impact of collaboration.

“This project shows how we can work together to try to improve health care for our patients, finding answers or solutions to some of the problems facing our health care system. This collaborative approach leads to great things for the University of Florida, and for the people we serve,” she said.