Safe Call Now Partner Dr. Michael Genovese |
As first
responders do we know anything about medication when it is prescribed to us
from our doctors? The side effects, if
it will actually work or not? This is
great information you need to know for your health and wellness. Stay safe out there!!!
Michael V. Genovese, M.D., J.D.
Chief Medical Officer – Sierra Tucson
Chief Medical Officer – Sierra Tucson
With the advancement
of medicine and the multitude of available options, psychiatrists face numerous
challenges in tailoring the appropriate course of individualized treatment for
patients. Pharmacogenomics is the study of how a person’s individual DNA
affects his or her response to medications and a scientific method of
evaluating which medications a patient is likely to tolerate. The primary role
of pharmacogenomics is to develop rational means to optimize drug therapy, with
respect to the patient’s genotype, to ensure maximum efficacy with
minimal adverse effects.
There are many
factors involved in the decision making process of administering medication
such as efficacy, side effect profile, compliance, cost, family history, and
the patient’s previous medication trials. Approximately 50% of patients do not
respond to their initial medication treatment and up to 30% discontinue due to
intolerable side effects. Additionally, nearly 70% of patients are non-adherent
to their prescribed medication schedule, with adverse reactions representing
the most common cause. The statistics reveal the demand for an individualized
approach to patient care and a treatment plan specific to the patient’s needs.
Pharmacogenomics
provides an evidence-based approach to improving customized treatment outcomes.
This personalized approach to medicine is safe and easy to accomplish. It
minimizes patient frustration associated with a trial and error approach to
pharmacology. Testing a patient is as simple as collecting cells from the
inside of the cheek with a cotton swab. The cells are sent to a lab and results
are generally available within a week. A detailed report provides patient
specific information regarding the genes that code for enzymes that are
responsible for metabolizing medication and regulating its activity at the
neuron.
Pharmacogenomics is a
cutting-edge approach to behavioral health medicine and a breakthrough in the
provision of comprehensive and tailored treatment plans. Information provided
within the report is invaluable to the physician and the patient. The data is
not dispositive; nor does it dictate that a certain medication must be
administered. Rather, it provides information about how the body breaks down
medications, the likelihood of side effects and the potential for efficacy
based upon the patient’s DNA. Thus we are able to more accurately predict
benefit, while simultaneously validating previous suboptimal attempts. We can
demonstrate that a patient’s inability to tolerate a prescribed medication was
not weakness but genetic predisposition. With the support of pharmacogenomics
data, physicians can more accurately dose a medication or confidently select an
alternative. A “best guess” is no longer necessary. Now we are able to marry
the art and science of medicine more successfully than we could in the past.
Research indicates
that patients experience up to 70% greater improvement when their treatment was
guided by pharmacogenomics testing. They appreciate the personalized data and
are much more responsive to their customized treatment plans. Well-informed
patients express a greater degree of confidence when entering into a treatment
modality and, as a result, are better equipped to experience success in the
healing process.
For over 30 years,
Sierra Tucson has helped to navigate the path of hope and healing. Our patients
come to us seeking health, wellbeing, and change. Our mission is to provide the
highest quality of compassionate care and clinical excellence with the most
comprehensive and individualized treatment plan specific to each patient.
Therefore, we embrace and effectuate the changing landscape of neurobiology to
function as successful advocates for our patients. The integration of
pharmacogenomics complements and enhances the evidence-based treatments already
offered at Sierra Tucson – where change begins.
Sources:
- Hall-Flavin DK, Winner JG, Allen JD, Carhart JM, Proctor B, Snyder KA, Drews MS, Eisterhold LL, Geske J, Mrazek DA. Utility of integrated pharmacogenomics testing to support the treatment of major depressive disorder in a psychiatric outpatient setting. Pharmacogenetics and Genomics. 2013;23(10):535-548.
- Hall-Flavin DK, Winner, JG, Allen JD, Jordan JJ, Nesheim RS, Snyder KA, Drews MS, Eisterhold LL, Biernacka JM, Mrazek DA. Using a pharmacogenomics algorithm to guide the treatment of depression. Transl Psychiatry. 2012;2:e 172.
- Winner JG, Carhart JM, Altar CA, Allen JD, Dechairo BM. A prospective, randomized double-blind study assessing the clinical impact of integrated pharmacogenomics testing for major depressive disorder. Discovery Med. 2013;16(89): 219-227.
- Winner JG, Allen JD, Altar CA, Spahic-Mihajlovic A. Psychiatric pharmacogenomics predicts health resource utilization of outpatients with anxiety and depression. Transl Psychiatry. 2013;3:e300. doi:10. 1038/tp.2013.2.
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