Clinical Utility of Applying PGx and Deprescribing-Based Decision Support in Polypharmacy

Polypharmacy is a necessary and important aspect of drug treatment; however, it becomes a challenge when the medication risks outweigh the benefits for an individual patient. Drug–drug interactions and the introduction of prescribing cascades are common features of polypharmacy, which can lead to in...

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Publicado: MDPI - Multidisciplinary Digital Publishing Institute 2023
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Acceso en línea:ONIX_20230220_9783036551623_83
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description Polypharmacy is a necessary and important aspect of drug treatment; however, it becomes a challenge when the medication risks outweigh the benefits for an individual patient. Drug–drug interactions and the introduction of prescribing cascades are common features of polypharmacy, which can lead to ineffectiveness and increased risk of adverse drug reactions (ADR). Genes encoding CYP450 isozymes and other drug-related biomarkers have attracted considerable attention as targets for pharmacogenetic (PGx) testing due to their impact on drug metabolism and response. This Special Issue is devoted to explore the status and initiatives taken to circumvent ineffectiveness and to improve medication safety for polypharmacy patients. Specific areas include drug–drug interactions and consequences thereof in therapeutic management, including PK- and PD-profiling; the application of PGx-based guidance and/or decision tools for drug–gene and drug–drug gene interactions; medication reviews; development and application of deprescribing tools; and drivers and barriers to overcome for successful implementation in the healthcare system.
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publisher MDPI - Multidisciplinary Digital Publishing Institute
publisherStr MDPI - Multidisciplinary Digital Publishing Institute
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spelling doab-20.500.12854ir-974802024-03-31T13:10:23Z Clinical Utility of Applying PGx and Deprescribing-Based Decision Support in Polypharmacy Vermehren, Charlotte Westergaard, Niels acute kidney injury early biomarker plasma neutrophil gelatinase-associated lipocalin soluble urokinase plasminogen activator receptor medication optimization older patients emergency department multimorbidity polypharmacy potentially inappropriate medication use older adults prevalence determinants chronic outpatient 2019 Beers criteria Ethiopia pharmacogenomics persons with diabetes drug–drug interactions drug–gene interactions cytochrome P450 SLCO1B1 drug interaction checkers adverse drug reactions pharmacogenetics personalized medicine phenprocoumon DOACs bleeding thromboembolism HLA drug hypersensitivity abacavir allopurinol flucloxacillin antiepileptic drugs cost-effectiveness shared medication record medication reconciliation drug information service hospital pharmacy service electronic prescribing electronic medical record clinical pharmacist CYP2D6 CYP2D7P CYP2D8P copy number variation CNV genotyping 5’nuclease assay HRM high resolution melting drug metabolization extracellular vesicles exosomes microvesicles pharmacogene expression medication review deprescriptions quality of life aged 80 and over nursing homes deprescribing medication-based risk score health outcomes cytochromes CYP1A2 adverse drug reaction antipsychotics olanzapine clozapine loxapine children youth digital decision-support health services research general practice process evaluation antidepressants utility population-based appropriateness medication adherence digital health thema EDItEUR::M Medicine and Nursing thema EDItEUR::K Economics, Finance, Business and Management::KN Industry and industrial studies::KND Manufacturing industries Polypharmacy is a necessary and important aspect of drug treatment; however, it becomes a challenge when the medication risks outweigh the benefits for an individual patient. Drug–drug interactions and the introduction of prescribing cascades are common features of polypharmacy, which can lead to ineffectiveness and increased risk of adverse drug reactions (ADR). Genes encoding CYP450 isozymes and other drug-related biomarkers have attracted considerable attention as targets for pharmacogenetic (PGx) testing due to their impact on drug metabolism and response. This Special Issue is devoted to explore the status and initiatives taken to circumvent ineffectiveness and to improve medication safety for polypharmacy patients. Specific areas include drug–drug interactions and consequences thereof in therapeutic management, including PK- and PD-profiling; the application of PGx-based guidance and/or decision tools for drug–gene and drug–drug gene interactions; medication reviews; development and application of deprescribing tools; and drivers and barriers to overcome for successful implementation in the healthcare system. 2023-02-20T16:46:28Z 2023-02-20T16:46:28Z 2022 book ONIX_20230220_9783036551623_83 9783036551623 9783036551616 https://directory.doabooks.org/handle/20.500.12854/97480 eng image/jpeg Attribution 4.0 International https://mdpi.com/books/pdfview/book/6018 MDPI - Multidisciplinary Digital Publishing Institute 10.3390/books978-3-0365-5161-6 10.3390/books978-3-0365-5161-6 46cabcaa-dd94-4bfe-87b4-55023c1b36d0 9783036551623 9783036551616 224 Basel open access
spellingShingle acute kidney injury
early biomarker
plasma neutrophil gelatinase-associated lipocalin
soluble urokinase plasminogen activator receptor
medication optimization
older patients
emergency department
multimorbidity
polypharmacy
potentially inappropriate medication use
older adults
prevalence
determinants
chronic
outpatient
2019 Beers criteria
Ethiopia
pharmacogenomics
persons with diabetes
drug–drug interactions
drug–gene interactions
cytochrome P450
SLCO1B1
drug interaction checkers
adverse drug reactions
pharmacogenetics
personalized medicine
phenprocoumon
DOACs
bleeding
thromboembolism
HLA
drug hypersensitivity
abacavir
allopurinol
flucloxacillin
antiepileptic drugs
cost-effectiveness
shared medication record
medication reconciliation
drug information service
hospital pharmacy service
electronic prescribing
electronic medical record
clinical pharmacist
CYP2D6
CYP2D7P
CYP2D8P
copy number variation
CNV
genotyping
5’nuclease assay
HRM
high resolution melting
drug metabolization
extracellular vesicles
exosomes
microvesicles
pharmacogene expression
medication review
deprescriptions
quality of life
aged
80 and over
nursing homes
deprescribing
medication-based risk score
health outcomes
cytochromes
CYP1A2
adverse drug reaction
antipsychotics
olanzapine
clozapine
loxapine
children
youth
digital decision-support
health services research
general practice
process evaluation
antidepressants
utility
population-based
appropriateness
medication adherence
digital health
thema EDItEUR::M Medicine and Nursing
thema EDItEUR::K Economics, Finance, Business and Management::KN Industry and industrial studies::KND Manufacturing industries
Clinical Utility of Applying PGx and Deprescribing-Based Decision Support in Polypharmacy
title Clinical Utility of Applying PGx and Deprescribing-Based Decision Support in Polypharmacy
title_full Clinical Utility of Applying PGx and Deprescribing-Based Decision Support in Polypharmacy
title_fullStr Clinical Utility of Applying PGx and Deprescribing-Based Decision Support in Polypharmacy
title_full_unstemmed Clinical Utility of Applying PGx and Deprescribing-Based Decision Support in Polypharmacy
title_short Clinical Utility of Applying PGx and Deprescribing-Based Decision Support in Polypharmacy
title_sort clinical utility of applying pgx and deprescribing based decision support in polypharmacy
topic acute kidney injury
early biomarker
plasma neutrophil gelatinase-associated lipocalin
soluble urokinase plasminogen activator receptor
medication optimization
older patients
emergency department
multimorbidity
polypharmacy
potentially inappropriate medication use
older adults
prevalence
determinants
chronic
outpatient
2019 Beers criteria
Ethiopia
pharmacogenomics
persons with diabetes
drug–drug interactions
drug–gene interactions
cytochrome P450
SLCO1B1
drug interaction checkers
adverse drug reactions
pharmacogenetics
personalized medicine
phenprocoumon
DOACs
bleeding
thromboembolism
HLA
drug hypersensitivity
abacavir
allopurinol
flucloxacillin
antiepileptic drugs
cost-effectiveness
shared medication record
medication reconciliation
drug information service
hospital pharmacy service
electronic prescribing
electronic medical record
clinical pharmacist
CYP2D6
CYP2D7P
CYP2D8P
copy number variation
CNV
genotyping
5’nuclease assay
HRM
high resolution melting
drug metabolization
extracellular vesicles
exosomes
microvesicles
pharmacogene expression
medication review
deprescriptions
quality of life
aged
80 and over
nursing homes
deprescribing
medication-based risk score
health outcomes
cytochromes
CYP1A2
adverse drug reaction
antipsychotics
olanzapine
clozapine
loxapine
children
youth
digital decision-support
health services research
general practice
process evaluation
antidepressants
utility
population-based
appropriateness
medication adherence
digital health
thema EDItEUR::M Medicine and Nursing
thema EDItEUR::K Economics, Finance, Business and Management::KN Industry and industrial studies::KND Manufacturing industries
topic_facet acute kidney injury
early biomarker
plasma neutrophil gelatinase-associated lipocalin
soluble urokinase plasminogen activator receptor
medication optimization
older patients
emergency department
multimorbidity
polypharmacy
potentially inappropriate medication use
older adults
prevalence
determinants
chronic
outpatient
2019 Beers criteria
Ethiopia
pharmacogenomics
persons with diabetes
drug–drug interactions
drug–gene interactions
cytochrome P450
SLCO1B1
drug interaction checkers
adverse drug reactions
pharmacogenetics
personalized medicine
phenprocoumon
DOACs
bleeding
thromboembolism
HLA
drug hypersensitivity
abacavir
allopurinol
flucloxacillin
antiepileptic drugs
cost-effectiveness
shared medication record
medication reconciliation
drug information service
hospital pharmacy service
electronic prescribing
electronic medical record
clinical pharmacist
CYP2D6
CYP2D7P
CYP2D8P
copy number variation
CNV
genotyping
5’nuclease assay
HRM
high resolution melting
drug metabolization
extracellular vesicles
exosomes
microvesicles
pharmacogene expression
medication review
deprescriptions
quality of life
aged
80 and over
nursing homes
deprescribing
medication-based risk score
health outcomes
cytochromes
CYP1A2
adverse drug reaction
antipsychotics
olanzapine
clozapine
loxapine
children
youth
digital decision-support
health services research
general practice
process evaluation
antidepressants
utility
population-based
appropriateness
medication adherence
digital health
thema EDItEUR::M Medicine and Nursing
thema EDItEUR::K Economics, Finance, Business and Management::KN Industry and industrial studies::KND Manufacturing industries
url ONIX_20230220_9783036551623_83