title: Prevalence of clinically actionable genotypes and medication exposure of older adults in the community.
abstract: This study analyzed clinically actionable pharmacogenotypes for clopidogrel, warfarin, statins, thiopurines, and tacrolimus using microarray data for 2121 participants (55-85 years) from the Australian Hunter Community Study (HCS). At least 74% of participants (95% confidence interval [CI]: 72%-76%) had strong level evidence for at least one medium- or high-risk actionable genotype that would trigger a change in standard therapy under current international recommendations. About 14% of these participants (95% CI: 12%-16%) were taking medication potentially affected by the genotype in question. Furthermore, ~2.6% of all participants with medication data (95% CI: 1.4%-3.8%) had a high-risk clinically actionable genotype for a medication to which they were exposed. This represents a considerable number of people at the population level. Although relationships between genotype and health outcomes remain contentious, pharmacogenotyping of multiple variants simultaneously may have considerable potential to improve medication safety and efficacy for older people in the community.
authors.affiliation: Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy; Faculty of Health and Medicine, Centre for Bioinformatics, Biomarker Discovery and Information-Based Medicine, The University of Newcastle, Callaghan.
authors.forename: Nilofar
authors.initials: N
authors.lastname: Daneshi
authors.affiliation: Clinical Research Design, IT and Statistical Support Unit, Hunter Medical Research Institute; Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health, University of Newcastle.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Holliday
authors.affiliation: Clinical Research Design, IT and Statistical Support Unit, Hunter Medical Research Institute; Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health, University of Newcastle.
authors.forename: Stephen
authors.initials: S
authors.lastname: Hancock
authors.affiliation: Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy; Faculty of Health and Medicine, Centre for Bioinformatics, Biomarker Discovery and Information-Based Medicine, The University of Newcastle, Callaghan.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Schneider
authors.affiliation: Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy; Faculty of Health and Medicine, Centre for Bioinformatics, Biomarker Discovery and Information-Based Medicine, The University of Newcastle, Callaghan; Hunter Area Pathology Service, John Hunter Hospital, Newcastle, NSW, Australia.
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Scott
authors.affiliation: Clinical Research Design, IT and Statistical Support Unit, Hunter Medical Research Institute; Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health, University of Newcastle.
authors.forename: John
authors.initials: J
authors.lastname: Attia
authors.affiliation: Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy; Faculty of Health and Medicine, Centre for Bioinformatics, Biomarker Discovery and Information-Based Medicine, The University of Newcastle, Callaghan.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Milward
keywords: actionable genotype; community; older adults; pharmacogenomics; pre-emptive genotyping; single-nucleotide polymorphism