Pharmacogenomic Data: A Useful Tool in Geriatric Medication Safety

The World Health Organization has identified medication without harm as an international global patient safety challenge (WHO, 2022). Healthcare professional education and training related to safe medication prescribing is a fundamental aspect of this initiative. Polypharmacy is common among older adults in long-term care settings and contributes to patient falls, risks of drug interactions, adverse side effects, functional impairment, and risk of hospitalizations (Wastesson, Morin, Tan, Johnell 2018). Therefore, employing tools designed for careful and systematic evaluation of prescribed medication is of critical importance for APRN’s treating geriatric patients. Pharmacogenomics (PGX) is the scientific study of gene/drug relationships and the resulting impact on individual drug response (Dere, Suto, 2009). PGX could be a useful medication safety tool deployed in long-term care settings. The purpose of this project was to evaluate the therapeutic impact of PGX testing in long term care. Specifically, PGX testing for patients using the following drug categories were included: antipsychotics, mood stabilizers, anxiolytics, hypnotics, antidepressants, stimulants, and non-stimulants. Buccal swabs containing genetic material were collected for 46 patients and PGX panel was completed for each patient. Of the 46 patients, 27% were male and 63% were female. The age range of patients was 53 to 96 years, with an average age of 75.3 years. Results are categorized as either a normal metabolizer, intermediate metabolizer, rapid metabolizer, or poor metabolizer. Of the drug categories tested, 42% of patients had a current medication fall into a category that required medication review, medication dose adjustment, or a medication substitution. An interprofessional team of APRNs, psychiatry, physicians, pharmacy, and nurses reviewed patient medication profiles and PGX results to determine best medication adjustments. Family and patients were educated regarding results and recommended changes to medication regimen. PGX data can be a valuable tool to assist healthcare providers in providing safe medications to geriatric populations. Understanding the science of PGX data and its role in preventing medication harm is essential for APRNs providing care to geriatric patients.