title: How does pharmacogenetic testing alter the treatment course and patient response for chronic-pain patients in comparison with the current "trial-and-error" standard of care?
abstract: OBJECTIVE
  To evaluate if pharmacogenetic testing (PT) holds value for pain-management practitioners by identifying the potential applications of pharmacogenetic research as well as applications in practice.
  
  
  METHODS
  A review of the literature was conducted utilizing the databases EBSCOhost, Biomedical Reference Collection, CINAHL, Health Business: Full Text, Health Source: Nursing/Academic Edition, and MEDLINE with the keywords, personalized medicine, cytochrome P450, and phamacogenetics.
  
  
  CONCLUSIONS
  Chronic-pain patients present some of the most challenging patients to manage medically. Often paired with persistent, life-altering pain, they might also have oncologic and psychological comorbidities that can further complicate their management. One-step in-office PT is now widely available to optimize management of complicated patients and affectively remove the "trial-and-error" process of medication therapy.
  
  
  CONCLUSIONS
  Practitioners must be familiar with the genetic determinants that affect a patient's response to medications in order to decrease preventable morbidity and mortality associated with drug-drug and patient-drug interactions, and to provide cost-effective care through avoidance of inappropriate medications. Improved pain managements will impove patient outcomes and satisfaction.
authors.affiliation: Family Nurse Practitioner Program, Department of Advanced Practice Nursing, College of Nursing, Health and Human Services, Indiana State University, Terre Haute, Indiana, 47809.
authors.forename: Kelly
authors.initials: K
authors.lastname: DeFeo
authors.forename: Kristen
authors.initials: K
authors.lastname: Sykora
authors.forename: Susan
authors.initials: S
authors.lastname: Eley
authors.forename: Debra
authors.initials: D
authors.lastname: Vincent
mesh_terms: D059350:Chronic Pain / Q000628:therapy*; D019468:Disease Management; D006801:Humans; D054539:Medication Therapy Management / Q000639:trends*; D017060:Patient Satisfaction; D010597:Pharmacogenetics / Q000379:methods*; D059039:Standard of Care / Q000639:trends*
keywords: Pharmacogenetics; genetics; pain management; patient care outcomes; pharmacotherapy