title: Precision Medicine at the University of Alabama at Birmingham: Laying the Foundational Processes Through Implementation of Genotype-Guided Antiplatelet Therapy.
abstract: Precision medicine entails tailoring treatment based on patients' unique characteristics. As drug therapy constitutes the cornerstone of treatment for most chronic diseases, pharmacogenomics (PGx), the study of genetic variation influencing individual response to drugs, is an important component of precision medicine. Over the past decade investigations have identified genes and single-nucleotide polymorphisms (SNPs) and quantified their effect on drug response. Parallel development of point-of-care (POC) genotyping platforms has enabled the interrogation of the genes/SNPs within a timeline conducive to the provision of care. Despite these advances, the pace of integration of genotype-guided drug therapy (GGTx) into practice has faced significant challenges. These include difficulty in identifying SNPs with sufficiently robust evidence to guide clinical decision making, lack of clinician training on how to order and use genotype data, lack of clinical decision support (CDS) to guide treatment, and limited reimbursement. The University of Alabama at Birmingham's (UAB) efforts in precision medicine were initiated to address these challenges and improve the health of the racially diverse patients we treat.
authors.affiliation: Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: S
authors.initials: S
authors.lastname: Harada
authors.affiliation: Department of Pathology, University of Oklahoma Health Sciences Center, Norman, Oklahoma, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: University of Alabama at Birmingham Health System, Birmingham, Alabama, USA.
authors.forename: S
authors.initials: S
authors.lastname: Duncan
authors.affiliation: University of Alabama at Birmingham Health System, Birmingham, Alabama, USA.
authors.forename: A R
authors.initials: AR
authors.lastname: Armstead
authors.affiliation: University of Alabama at Birmingham Health System, Birmingham, Alabama, USA.
authors.forename: G M
authors.initials: GM
authors.lastname: Coshatt
authors.affiliation: Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: C
authors.initials: C
authors.lastname: Dillon
authors.affiliation: Department of Medicine, Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: B C
authors.initials: BC
authors.lastname: Brott
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: J
authors.initials: J
authors.lastname: Willig
authors.affiliation: University of Alabama at Birmingham Health System, Birmingham, Alabama, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Alsip
authors.affiliation: Heart South Cardiovascular Group, Birmingham, AL.
authors.forename: W B
authors.initials: WB
authors.lastname: Hillegass
authors.affiliation: Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: N A
authors.initials: NA
authors.lastname: Limdi
mesh_terms: D000407:Alabama; D020000:Decision Support Systems, Clinical; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D010597:Pharmacogenetics; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019095:Point-of-Care Systems; D020641:Polymorphism, Single Nucleotide; D057285:Precision Medicine / Q000379:methods*; D014495:Universities
chemical_list: D010975:Platelet Aggregation Inhibitors