title: Implementation of pharmacogenetics: the University of Maryland Personalized Anti-platelet Pharmacogenetics Program.
abstract: Despite a substantial evidence base, implementation of pharmacogenetics into routine patient care has been slow due to a number of non-trivial practical barriers. We implemented a Personalized Anti-platelet Pharmacogenetics Program (PAP3) for cardiac catheterization patients at the University of Maryland Medical Center and the Baltimore Veterans Administration Medical Center Patients' are offered CYP2C19 genetic testing, which is performed in our Clinical Laboratory Improvement Amendment (CLIA)-certified Translational Genomics Laboratory. Results are returned within 5 hr along with clinical decision support that includes interpretation of results and prescribing recommendations for anti-platelet therapy based on the Clinical Pharmacogenetics Implementation Consortium guidelines. Now with a working template for PAP3, implementation of other drug-gene pairs is in process. Lessons learned as described in this article may prove useful to other medical centers as they implement pharmacogenetics into patient care, a critical step in the pathway to personalized and genomic medicine.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Shuldiner
authors.forename: Kathleen
authors.initials: K
authors.lastname: Palmer
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Pakyz
authors.forename: Tameka D
authors.initials: TD
authors.lastname: Alestock
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Maloney
authors.forename: Courtney
authors.initials: C
authors.lastname: O'Neill
authors.forename: Shaun
authors.initials: S
authors.lastname: Bhatty
authors.forename: Jamie
authors.initials: J
authors.lastname: Schub
authors.forename: Casey Lynnette
authors.initials: CL
authors.lastname: Overby
authors.forename: Richard B
authors.initials: RB
authors.lastname: Horenstein
authors.forename: Toni I
authors.initials: TI
authors.lastname: Pollin
authors.forename: Mark D
authors.initials: MD
authors.lastname: Kelemen
authors.forename: Amber L
authors.initials: AL
authors.lastname: Beitelshees
authors.forename: Shawn W
authors.initials: SW
authors.lastname: Robinson
authors.forename: Miriam G
authors.initials: MG
authors.lastname: Blitzer
authors.forename: Patrick F
authors.initials: PF
authors.lastname: McArdle
authors.forename: Lawrence
authors.initials: L
authors.lastname: Brown
authors.forename: Linda Jo Bone
authors.initials: LJ
authors.lastname: Jeng
authors.forename: Richard Y
authors.initials: RY
authors.lastname: Zhao
authors.forename: Nicholas
authors.initials: N
authors.lastname: Ambulos
authors.forename: Mark R
authors.initials: MR
authors.lastname: Vesely
mesh_terms: D000046:Academic Medical Centers / Q000379:methods* / Q000639:trends; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics; D006328:Cardiac Catheterization / Q000379:methods; D065731:Cytochrome P-450 CYP2C19; D005820:Genetic Testing / Q000379:methods; D006801:Humans; D008396:Maryland; D010597:Pharmacogenetics / Q000379:methods* / Q000639:trends; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D057285:Precision Medicine / Q000379:methods* / Q000639:trends; D016730:Program Development / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D010975:Platelet Aggregation Inhibitors; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19
keywords: CYP2C19; anti-platelet pharmacogenetics; clopidogrel; implementation science; individualized medicine; personalized medicine; pharmacogenomics; translational research