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Psych Congress  

Medication Optimization Using Pharmacogenomic Testing and a Drug Interaction Guide in a Complex Mental Health Population


Amanda Wood, PhD – VA Puget Sound Health Care System; Luz Stark, MD – VA Puget Sound Health Care System; Deepika Agrawal, MD – VA Puget Sound Health Care System; Terri Dupper-Knoper, ARNP – VA Puget Sound Health Care System; Rosa Merino, MD – Department of Defense; Alison Deem, MD – VA Puget Sound Health Care System; Sonia Lim, MD – VA Puget Sound Health Care System; Zohra Lodin, MD – VA Puget Sound Health Care System

Seed Grant from VHA Research & Development, and an Investigator Initiated Grant from Genomind Incorporated.

Background: Psychiatric polypharmacy may be an indication of complex mental health needs that require careful consideration in medication treatment planning to avoid drug-drug interactions and unwanted side effects. Pharmacogenomic (PGx) assays, such as the Genecept® Assay produced by Genomind, have the purported benefit of being able to predict response(s) to specific medications based on genetic markers. In addition, Genomind has developed the Genomind Drug Interaction Guide (G-DIG), a computerized decision tool that uses the genetic assay information to review a patient’s medication regimen for any relevant drug-drug-gene interactions.

Methods: This 14-week pilot study examined the clinical impact of provider access to PGx results and the G-DIG tool in Veterans prescribed polypharmacy, defined as 5 or more mediations with at least 2 for a mental health indication. Psychiatric medication providers were given access to the information, but were allowed to make their own decisions regarding medication management.

Results: Veteran outpatients (N = 49) prescribed polypharmacy (Mean = 13.15 medications) were enrolled into the study. Clinical improvement was seen in depression (F(1.63, 45) = 5.45, p = .01, η2 = .11) and mental health quality of life (Wilks’ Lambda = .84, F(2, 45) = 4.16, p < .05, η2 = .16). Rates of polypharmacy remained unchanged.

Discussion: Participants saw significant clinical improvement in depression and quality of life over the 14-week trial, suggesting that the medication changes based on the PGx assay results were beneficial, particularly in a medically complex patient population prescribed psychiatric polypharmacy.

This poster was presented at the 32nd annual Psych Congress, held Oct. 3-6, 2019, in San Diego, California.

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