Poor adherence is associated with worse disease outcomes. Pharmacogenomics provides a possible intervention to address adherence. We hypothesized that pharmacogenomic‐informed care could increase adherence. Patients in a prospective case‐control study underwent preemptive pharmacogenomic genotyping with results available for provider use at the point of care; controls (not genotyped) were treated by the same providers. Over 6,000 e‐prescriptions for 39 medications with actionable pharmacogenomic information were analyzed. Composite adherence, measured by modified proportion of days covered (mPDC), was compared between cases/controls and genomically concordant vs. genomically higher‐risk medications. Overall, 536 patients were included. No difference in mean mPDC was observed due to availability of pharmacogenomic guidance. However, case patients prescribed high‐risk pharmacogenomic medications were more than twice as likely to have low mPDC for these medications compared with genomically concordant prescriptions (odds ratio = 2.4 (1.03–5.74), P  < 0.05). This study is the first to show that composite pharmacogenomic information predicts adherence.

中文翻译：

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基于药物基因组学的决策支持来预测药物依从性。


依从性差与更差的疾病结果相关。药物基因组学为解决依从性问题提供了可能的干预措施。我们假设药物基因组学护理可以提高依从性。前瞻性病例对照研究中的患者接受了先发性药物基因组基因分型，结果可供提供者在护理时使用；对照（未进行基因分型）由相同的提供者进行治疗。分析了 39 种药物的 6,000 多个电子处方以及可操作的药物基因组信息。通过修正的覆盖天数比例 (mPDC) 来衡量，比较病例/对照以及基因组一致药物与基因组高风险药物之间的综合依从性。总共包括 536 名患者。由于药物基因组学指导的可用性，未观察到平均 mPDC 的差异。然而，与基因组一致的处方相比，服用高风险药物基因组药物的病例患者出现低 mPDC 的可能性是其两倍多（比值比 = 2.4 (1.03–5.74)， P < 0.05）。这项研究首次表明复合药物基因组信息可预测依从性。