Objective:To describe the initial results of implementing pharmacogenomics testing in a community-based psychiatry practice and potential impacts on medication management.Method:Retrospective chart review of prospectively maintained medical records of all adult patients with pharmacogenomics results from 9/01/2017 to 6/30/2019 under the care of psychiatrist and clinical pharmacist.Results:A total of 51 patients met inclusion criteria. A total of 7 pharmacokinetic genes and, due to changes in the test report over time, a range of 6-10 pharmacodynamic genes relevant to psychotropic medications were evaluated per patient. Every patient had genetic variations, with an average of 6.1 per patient (range 3-9; SD= 1.5). Patients were taking an average of 3.6 (range 1-8; SD=1.7) psychiatric medications at the time of the genetic test, to treat an average of 5 psychiatric conditions (range 1-9; SD=2.2). An average of 1.2 (range 0-4; SD=1.0) gene-drug interactions were uncovered per patient. Following review by psychiatrist and pharmacist, medication adjustments resulted in patients remaining on an average of 3.6 psychiatric medications, but decreasing the average number of gene-drug interactions per patient to 0.8 (range 0-3, SD=0.8).Discussion:The large number of genetic variations observed per patient is consistent with previous findings 1-2. The decrease in number of gene-drug interactions following testing demonstrates the practical utility of pharmacogenomics information to guide medication therapy. This study did not examine outcomes such as improvement in psychiatric condition or reduction in medication adverse effects; however, these endpoints have been evaluated in other trials 3-4.Conclusions:Pharmacogenomics testing presents an opportunity for a personalized medicine approach in a community-based psychiatry practice.

中文翻译：

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110 在社区精神病学实践中实施个性化医疗

目的：描述在以社区为基础的精神病学实践中实施药物基因组学测试的初步结果以及对药物管理的潜在影响。方法：回顾性图表审查所有成年患者的前瞻性医疗记录，从 2017 年 9 月 1 日至 6 日的药物基因组学结果/30/2019 在精神科医生和临床药师的监护下。结果：共有 51 名患者符合纳入标准。总共评估了 7 个药代动力学基因，并且由于测试报告随时间的变化，每位患者评估了 6-10 个与精神药物相关的药效学基因。每名患者都有遗传变异，平均每名患者有 6.1 个（范围 3-9；SD=1.5）。在基因测试时，患者平均服用 3.6（范围 1-8；SD=1.7）精神科药物，平均治疗 5 种精神疾病（范围 1-9；SD=2.2）。每位患者平均发现 1.2（范围 0-4；SD=1.0）基因-药物相互作用。经过精神科医生和药剂师的审查，药物调整导致患者平均保留 3.6 种精神科药物，但将每位患者的基因-药物相互作用的平均数量减少到 0.8（范围 0-3，SD=0.8）。讨论：大每个患者观察到的遗传变异数与之前的发现 1-2 一致。测试后基因-药物相互作用数量的减少证明了药物基因组学信息在指导药物治疗方面的实用性。本研究未检查精神状况改善或药物不良反应减少等结果；然而，