scholarly journals Impact of Previous Genetic Counseling and Objective Numeracy on Accurate Interpretation of a Pharmacogenetics Test Report

2021 ◽  
pp. 1-7
Author(s):  
Kelly Drelles ◽  
Robert Pilarski ◽  
Kandamurugu Manickam ◽  
Abigail B. Shoben ◽  
Amanda Ewart Toland
Keyword(s):  
Genetic Counseling ◽  
General Population ◽  
Adverse Drug Events ◽  
Medication Management ◽  
Drug Efficacy ◽  
Management Decision ◽  
Genetic Knowledge ◽  
Test Interpretation ◽  
Test Report ◽  
Genetic Literacy

<b><i>Introduction:</i></b> Pharmacogenetic (PGx) testing can be useful for providing information about a patient’s drug response by increasing drug efficacy and decreasing the incidence of adverse drug events. While PGx tests were previously only offered to patients under healthcare provider supervision, they are now available as direct to consumer (DTC) tests. This study aimed to assess how accurately individuals from the general population were able to interpret a sample PGx test report and if accuracy differed based on individuals’ numeracy or prior genetic counseling (GC). <b><i>Methods:</i></b> We surveyed 293 individuals from the general population, ascertained through ResearchMatch. The survey included questions about PGx test interpretation, numeracy, and genetic literacy. <b><i>Results:</i></b> In our cohort, numeracy level impacted PGx result interpretation, with those of high numeracy performing statistically significantly better on both the table format and graphical format (<i>p</i> value = 0.002 and <i>p</i> value &#x3c;0.001, respectively) and genetic knowledge questions (<i>p</i> value &#x3c;0.001) than those with low/average numeracy. In addition, previous GC did not impact test interpretation or genetic knowledge, but the number of individuals with prior GC was small (<i>n</i> = 26). <b><i>Discussion/Conclusion:</i></b> We found that numeracy had a significant impact on correct interpretation of PGx test reports. Because many individuals in the USA have low numeracy levels, it is extremely important that patients do not make their own medication management decision based on the test results and that they consult with their physicians about their PGx testing. The importance of consultation and discussion with providers about results should be emphasized on the test report.

scholarly journals MOKSLAS, GENETINĖS ŽINIOS IR ŽMOGAUS KŪNAS

Problemos ◽  
2012 ◽  
Vol 81 ◽  
pp. 67-78 ◽  
Author(s):  
Charalambos Tsekeris ◽  
George Alexias
Keyword(s):  
Genetic Counseling ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Human Body ◽  
Scientific Knowledge ◽  
Genetic Knowledge ◽  
Theoretical Literature ◽  
Emergent Discourse ◽  
Bodily Knowledge

Straipsnyje apžvelgiamas mokslo ir mokslinio pažinimo dinaminis pobūdis besikeičiančioje biotechnologijų eroje, taip pat besiformuojantis genetizacijosdiskursas ir jo reikšmė genetiniam konsultavimui (akcentuojant Huntingtono ligą) ir žmogaus kūnui. Žvelgiant iš daugiadalykės perspektyvos, siekiamanuodugniai ištirti ir kritiškai įvertinti šiuolaikinę kritinę literatūrą, skirtą šiems atskiriems, tačiau susipynusiems klausimams. Straipsnyje taip pat kviečiamasvarstyti, ką reiškia būti žmogumi ir kaip tvarkyti genetinį ir kūno pažinimą bei praktikas.Pagrindiniai žodžiai: mokslas, genetinis pažinimas, žmogaus kūnas, gamta, etika.Science, Genetic Knowledge and the Human BodyCharalambos Tsekeris, George Alexias SummaryThis paper aims to overview the dynamical character of science and scientific knowledge within the changing biotechnological era, as well as the emergent discourse of geneticization and its relevance to genetic counseling (with particular emphasis on Huntington’s Disease) and the human body. Its mainpurpose is to carefully explore and comprehensively critique the contemporary theoretical literature on these distinct but interdependent issues from an interdisciplinary standpoint. The paper encourages further critical contributions to thinking about what it means to be human, as well as about how to copewith current genetic and bodily knowledge and practices.Key words: science, genetic knowledge, human body, nature, ethics.

Perioperative Medication Management: Reconciling Differences across Clinical Sites

2018 ◽  
Vol 7 (1) ◽  
pp. 44-51 ◽  
Author(s):  
Benjamin J. Duncan ◽  
Lu Zheng ◽  
Stephanie K. Furniss ◽  
Bradley N. Doebbeling ◽  
Adela Grando ◽  
...  
Keyword(s):  
Adverse Drug Events ◽  
Quality Care ◽  
Medication Management ◽  
Task Completion ◽  
Interface Elements ◽  
Interactive Behavior ◽  
Modes Of Interaction ◽  
Interface Usability ◽  
Critical Process ◽  
Perioperative Medication

Medication reconciliation (MedRec) is a mission-critical process which can serve to reduce adverse drug events (ADEs) in surgical settings. However, providing quality care is limited by current health information technology (IT), which is often inefficient and unintuitive due to poor usability, resulting in high cognitive burden. We have been characterizing EHR mediated workflow in the Mayo Clinic enterprise prior to a system-wide electronic health records (EHR) conversion in order to harmonize workflows. We compared and evaluated MedRec processes in pre-operative nursing assessments across two different EHRs in place in different locales at baseline. The interfaces differed both in their modes of interaction and cognitive support. Analyses surfaced interface elements that were unintuitive and inefficient, creating unnecessary complexities in clinicians’ interactive behavior. Keystroke level models (KLM), a modeling tool for predicting task completion time, showed that to access medication lists required a different series of operations across the two systems. Different designs can differentially mediate task performance, which can aid in the mitigation of errors for complex cognitive tasks. Identification of barriers in EHR-mediated workflow and barriers to interface usability could lead to system redesigns that minimize cognitive load while improving patient safety and efficiency.

Evaluation of Adverse Drug Events and Medication Discrepancies in Transitions of Care Between Hospital Discharge and Primary Care Follow-Up

2014 ◽  
Vol 29 (2) ◽  
pp. 132-137 ◽  
Author(s):  
Becky L. Armor ◽  
Avery J. Wight ◽  
Sandra M. Carter
Keyword(s):  
Primary Care ◽  
Hospital Discharge ◽  
Medication Reconciliation ◽  
Adverse Drug Events ◽  
Medication Management ◽  
Transitions Of Care ◽  
Therapeutic Monitoring ◽  
Medication List ◽  
Medication Discrepancies

Approximately two-thirds of adverse events posthospital discharge are due to medication-related problems. Medication reconciliation is a strategy to reduce medication errors and improve patient safety. Objective: To evaluate adverse drug events (ADEs), potential ADEs (pADEs), and medication discrepancies occurring between hospital discharge and primary care follow-up in an academic family medicine clinic. Adult patients recently discharged from the hospital were seen by a pharmacist for medication reconciliation between September 1, 2011, and November 30, 2012. The pharmacist identified medication discrepancies and pADEs or ADEs from a best possible medication history obtained from the electronic medical record (EMR) and hospital medication list. In 43 study participants, an average of 2.9 ADEs or pADEs was identified ( N = 124). The most common ADEs/pADEs identified were nonadherence/underuse (18%), untreated medical problems (15%), and lack of therapeutic monitoring (13%). An average of 3.9 medication discrepancies per participant was identified (N = 171), with 81% of participants experiencing at least 1 discrepancy. The absence of a complete and accurate medication list at hospital discharge is a barrier to comprehensive medication management. Strategies to improve medication management during care transitions are needed in primary care.

scholarly journals Introduction to Molecular Genetic Diagnostics / UVOD U MOLEKULARNU GENETIČU DIJAGNOSTIKU

2014 ◽  
Vol 33 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Ivana Novaković ◽  
Nela Maksimović ◽  
Aleksandra Pavlović ◽  
Milena Žarković ◽  
Branislav Rovčanin ◽  
...  
Keyword(s):  
Genetic Counseling ◽  
Genetic Testing ◽  
Single Gene ◽  
Molecular Genetic ◽  
Drug Efficacy ◽  
Genetic Diagnostics ◽  
Molecular Genetic Testing ◽  
Main Method ◽  
Molecular Genetic Diagnostics ◽  
Modern Medical Practice

Summary Molecular genetic testing is part of modern medical practice. DNA tests are an essential part of diagnostics and genetic counseling in single gene diseases, while their application in polygenic disorders is still limited. Pharmacogenetics studies DNA variants associated with variations in drug efficacy and toxicity, and tests in this field are being developed rapidly. The main method for molecular genetic testing is the polymerase chain reaction, with a number of modifications. New methods, such as next generation sequencing and DNA microarray, should allow simultaneous analysis of a number of genes, even whole genome sequencing. Ethical concerns in molecular genetic testing are very important, along with legislation. After molecular genetic testing, interpretation of results and genetic counseling should be done by professionals. With the example of thrombophilia, we discuss questions about genetic testing, its possibilities and promises.

Improving medication reconciliation in ambulatory cancer care.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 224-224
Author(s):  
Carissa Milley-Daigle ◽  
Celina Dara ◽  
Genevieve Bouchard-Fortier ◽  
Anet Julius ◽  
Vishal Kukreti ◽  
...  
Keyword(s):  
Medication Reconciliation ◽  
Adverse Drug Events ◽  
Medication Management ◽  
Median Number ◽  
Medication History ◽  
Time Motion ◽  
Motion Study ◽  
Study Results ◽  
Ambulatory Oncology ◽  
Medication Documentation

224 Background: Adverse drug events are common in ambulatory oncology where care spans multiple providers and medication documentation is often poor. We undertook a QI project with the aim of having 30% of patients have a best possible medication history (BPMH) or medication reconciliation (MedRec) documented within 30 days of starting systemic therapy. Methods: An Electronic Medical record-Integrated Tool (EMITT) was developed to facilitate documentation. 2 Plan-Do-Study-Act (PDSA) cycles have been completed to date; PDSA 1 consisted of piloting EMITT in 3 clinics run by physician champions. PDSA 2 which consisted of expanding pharmacy support and addition of a 4th clinic was impacted by care changes related to COVID. The proportion of patients with BPMH/MedRec documented in EMITT was calculated monthly for each period (PDSA 1, PDSA 2 pre-COVID and PDSA 2 post-COVID). The balancing measure of time to complete an entry was evaluated through a time motion study. Results: Between 9/9/2019 and 31/5/2020, 9.4% (233/2488) of patients had BPMH/MedRec completed; Table shows proportion of patients by month. BPMH and MedRec were most frequently performed by pharmacists followed by pharmacy students and nurses. On average, it took 5.5 minutes to complete an entry (n = 10; median number of medications per patient = 12.3). Conclusions: BPMH was documented more often than MedRec. While some usage was sustained, the changes to care as a result of COVID-19 negatively impacted ambulatory medication reconciliation. Future PDSA cycles will involve engaging patients in MedRec and extending EMITT to all ambulatory cancer clinics where medication management is a major component of care. [Table: see text]

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