What if an under-used type of genetic testing combined with state-of-the-art clinical decision support software could cut ER visits by more than half and reduce hospitalizations by a third in the elderly?
New research has found that the YouScript Personalized Prescribing System, combining pharmacogenetic testing and patented medication management software, can do just that.
Preliminary data from a soon-to-be-published study has shown that YouScript testing and clinical decision support software reduced ER visits by 71 percent and hospitalizations by 39 percent in an elderly population, compared to those who did not receive testing. YouScript intervention also resulted in marked decreases in average, per-patient medical costs in just four months.
The research looked at patients 65 and older taking three or more prescription medications, including one known to be impacted by genetic variability.
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“To our knowledge, this is the first study to demonstrate a technology able to reduce the adverse drug event epidemic caused by polypharmacy [taking multiple medications at the same time],” Genelex co-founder and CEO Howard Coleman said.
The elderly patients included in the study were tested for variations in six genes (CYP2D6, CYP2C9, CYP2C19, CYP3A4, CYP3A5, sometimes collectively called “CYPs”, and VKORC1). Variations in these genes can affect how individuals process many of the most commonly prescribed medications.
The YouScript Solution
YouScript pharmacogenetic testing reveals genetic variations that determine how the body metabolizes many of the most commonly prescribed medications. The testing reduces “trial-and-error” prescribing by enabling doctors to select a safe and effective drug option at an appropriate dose up-front, thereby increasing the patient’s chance of successfully responding to treatment.
Genelex’s patented YouScript software analyzes genetic data and helps doctors, pharmacists, nurse practitioners and physician assistants identify patients that will benefit from genetic testing and those at greatest risk for potentially dangerous interactions. The software also provides medication management suggestions, accounting for the cumulative impact of all significant drug and genetic interactions. This allows providers to truly personalize each patient’s medication regimen.
Polypharmacy in the Elderly
Polypharmacy is defined as the “use of multiple medications or more than are medically necessary.” The elderly are more likely to suffer from of polypharmacy-related negative clinical consequences, which include adverse drug events, drug interactions, medication non-adherence, functional decline and increased healthcare costs.
Additionally, the effects of polypharmacy can be compounded by natural genetic differences in how they respond to drugs, further increasing the risk of these unintended consequences.
Healthcare providers have called polypharmacy a serious problem needing special attention. What’s more, the prevalence of polypharmacy is clear. Consider these statistics:
- On average, individuals 65 to 69 years old take nearly 14 prescriptions per year, while those 80 to 84 take an average of 18 prescriptions annually
- At any given time, an average elderly person uses between four and five prescription drugs and two over-the-counter medications
- One out of every five elderly Americans is taking medications that “may adversely affect coexisting conditions”
- Between 15 percent and 25 percent of drug use in seniors is considered unnecessary or otherwise inappropriate
Limited Medicare Coverage
Despite the growing body of evidence supporting the association between genetic variations and drug response, Medicare recently limited coverage of many of the tests for these variations. Payment denial could impact as many as 19 million of the 49 million Medicare beneficiaries in the U.S. who are at special risk of costly adverse drug events.
“Medicare is simultaneously fining hospitals for readmissions which are often caused by adverse drug events, while limiting coverage for the very tests that could reduce them,” Genelex Chief Operating Officer Kristine Ashcraft said.
“This is counter to the Triple Aim, and negatively impacts patient care and the bottom line.”
For more information on this research, contact Kristine Ashcraft at KAshcraft@genelex.com or by phone at 206-826-1957.
Dr. Diana Brixner, PhD, RPh, Professor in the Department of Pharmacotherapy at the University of Utah College of Pharmacy, is the primary investigator for this research. Genelex Director of Pharmacy Tyler Mamiya, PharmD, co-authored the study, which is expected be published in the Journal of Medical Economics later this year. Genelex provided an unrestricted grant to fund this research.
At the end of October, Dr. Brixner will present the research at the Academy of Managed Care Pharmacy Nexus 2015 conference in Orlando, Fla.