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Clinician adherence to pharmacogenomics prescribing recommendations in clinical decision support alerts

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Jenny Q Nguyen,
Jenny Q Nguyen
Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital
, Memphis, Tennessee,
USA
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Kristine R Crews,
Kristine R Crews
Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital
, Memphis, Tennessee,
USA
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Ben T Moore,
Ben T Moore
Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital
, Memphis, Tennessee,
USA
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Nancy M Kornegay,
Nancy M Kornegay
Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital
, Memphis, Tennessee,
USA
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Donald K Baker,
Donald K Baker
Department of Information Services, St. Jude Children’s Research Hospital
, Memphis, Tennessee,
USA
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Murad Hasan,
Murad Hasan
Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital
, Memphis, Tennessee,
USA
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Patrick K Campbell,
Patrick K Campbell
Department of Information Services, St. Jude Children’s Research Hospital
, Memphis, Tennessee,
USA
Department of Oncology, St. Jude Children’s Research Hospital
, Memphis, Tennessee,
USA
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Shannon M Dean,
Shannon M Dean
Department of Information Services, St. Jude Children’s Research Hospital
, Memphis, Tennessee,
USA
Department of Pediatrics, St. Jude Children’s Research Hospital
, Memphis, Tennesse,
USA
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Mary V Relling,
Mary V Relling
Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital
, Memphis, Tennessee,
USA
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James M Hoffman,
James M Hoffman
Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital
, Memphis, Tennessee,
USA
Department of the Office of Quality and Patient Safety, St. Jude Children’s Research Hospital
, Memphis, Tennesse,
USA
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Journal of the American Medical Informatics Association, Volume 30, Issue 1, January 2023, Pages 132–138,https://doi.org/10.1093/jamia/ocac187
Published:
13 October 2022
Article history
Received:
07 July 2022
Revision received:
26 September 2022
Editorial decision:
28 September 2022
Accepted:
02 October 2022
Published:
13 October 2022
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Abstract

Thoughtful integration of interruptive clinical decision support (CDS) alerts within the electronic health record is essential to guide clinicians on the application of pharmacogenomic results at point of care. St. Jude Children’s Research Hospital implemented a preemptive pharmacogenomic testing program in 2011 in a multidisciplinary effort involving extensive education to clinicians about pharmacogenomic implications. We conducted a retrospective analysis of clinicians’ adherence to 4783 pharmacogenomically guided CDS alerts that triggered for 12 genes and 60 drugs. Clinicians adhered to the therapeutic recommendations provided in 4392 alerts (92%). In our population of pediatric patients with catastrophic illnesses, the most frequently presented gene/drug CDS alerts wereTPMT/NUDT15 and thiopurines (n = 3850),CYP2D6 and ondansetron (n = 667),CYP2D6 and oxycodone (n = 99),G6PD and G6PD high-risk medications (n  = 51), andCYP2C19 and proton pump inhibitors (omeprazole and pantoprazole;n = 50). The high adherence rate was facilitated by our team approach to prescribing and our collaborative CDS design and delivery.

© The Author(s) 2022. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email:[email protected]
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)
Issue Section:
Brief Communication
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Journal of the American Medical Informatics Association
  • Online ISSN 1527-974X
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