United States Emergency Department Use of Medications with Pharmacogenetic Recommendations.

Journal Article (Journal Article)

INTRODUCTION: Emergency departments (ED) use many medications with a range of therapeutic efficacy and potential significant side effects, and many medications have dosage adjustment recommendations based on the patient's specific genotype. How frequently medications with such pharmaco-genetic recommendations are used in United States (US) EDs has not been studied. METHODS: We conducted a cross-sectional analysis of the 2010-2015 National Hospital Ambulatory Medical Care Survey (NHAMCS). We reported the proportion of ED visits in which at least one medication with Clinical Pharmacogenetics Implementation Consortium (CPIC) recommendation of Level A or B evidence was ordered. Secondary comparisons included distributions and 95% confidence intervals of age, gender, race/ethnicity, ED disposition, geographical region, immediacy, and insurance status between all ED visits and those involving a CPIC medication. RESULTS: From 165,155 entries representing 805,726,000 US ED visits in the 2010-2015 NHAMCS, 148,243,000 ED visits (18.4%) led to orders of CPIC medications. The most common CPIC medication was tramadol (6.3%). Visits involving CPIC medications had higher proportions of patients who were female, had private insurance and self-pay, and were discharged from the ED. They also involved lower proportions of patients with Medicare and Medicaid. CONCLUSION: Almost one fifth of US ED visits involve a medication with a pharmacogenetic recommendation that may impact the efficacy and toxicity for individual patients. While direct application of genotyping is still in development, it is important for emergency care providers to understand and support this technology given its potential to improve individualized, patient-centered care.

Full Text

Duke Authors

Cited Authors

  • Limkakeng, AT; Manandhar, P; Erkanli, A; Eucker, SA; Root, A; Voora, D

Published Date

  • September 23, 2021

Published In

Volume / Issue

  • 22 / 6

Start / End Page

  • 1347 - 1354

PubMed ID

  • 34787561

Pubmed Central ID

  • PMC8597689

Electronic International Standard Serial Number (EISSN)

  • 1936-9018

Digital Object Identifier (DOI)

  • 10.5811/westjem.2021.5.51248


  • eng

Conference Location

  • United States