Pharmacogenomic Testing and Patient Perception Inform Pain Pharmacotherapy

(1) Background: Chronic pain is one of the most common reasons for individuals to seek medications. Historically, opioids have been the mainstay of chronic pain management. However, in some patient populations, opioids fail to demonstrate therapeutic efficacy, whereas in other populations, opioids m...

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Main Authors: Feng-Hua Loh, Brigitte Azzi, Alexander Weingarten, Zvi G. Loewy
Format: Article
Language:English
Published: MDPI AG 2021-10-01
Series:Journal of Personalized Medicine
Subjects:
Online Access:https://www.mdpi.com/2075-4426/11/11/1112
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author Feng-Hua Loh
Brigitte Azzi
Alexander Weingarten
Zvi G. Loewy
author_facet Feng-Hua Loh
Brigitte Azzi
Alexander Weingarten
Zvi G. Loewy
author_sort Feng-Hua Loh
collection DOAJ
description (1) Background: Chronic pain is one of the most common reasons for individuals to seek medications. Historically, opioids have been the mainstay of chronic pain management. However, in some patient populations, opioids fail to demonstrate therapeutic efficacy, whereas in other populations, opioids may cause toxic effects, even at lower doses. Response to pain medication is affected by many factors, including an individual’s genetic variations. Pharmacogenomic testing has been designed to help achieve optimal treatment outcomes. This study aimed at assessing the impact of CYP2D6 pharmacogenomic testing on physicians’ choice in prescribing chronic pain medications and patient pain control. (2) Methods: This retrospective study reviewed 107 patient charts from a single site pain management center. All 107 patients received pharmacogenomic testing. The outcomes of interest were confirmation that the optimal pain medication is being administered or a change in the chronic pain medication is warranted as a result of the pharmacogenomic testing. The main independent variable was the pharmacogenomic test result. Other independent variables included patient gender, race, and comorbidities. The retrospective study was reviewed and approved by the Touro College and University System IRB, HSIRB1653E. (3) Results: Patients self-reported pain intensity on a scale of 1–10 before and after pharmacogenomic testing. Then, 100% of patients in the retrospective study were tested for their pain pharmacogenomic profile. Of the 107 patients participating in the study, more than 50% had their medications altered as a result of the pharmacogenomic testing. The percentage of patients with intense pain were decreased post-pharmacogenomic testing (5.6%) as compared to pre-pharmacogenomic testing (10.5%). Patients with intense, moderate, and mild pain categories were more likely to receive changes in pain medications. In contrast, patients with severe pain were less likely to receive a change in pain medication. Hispanic ethnicity was associated with a statistically significantly decrease in a pain scale category. Illegal drug abuse was associated with a decrease in pain scale category. Change in medication dose was associated with a decrease in pain scale category. (4) Conclusion: In this retrospective study, implementation of pharmacogenomic testing demonstrated significant benefits to patients with intense pain undergoing treatment.
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spelling doaj.art-209b9af25ce8407883de29e7c427511f2023-11-22T23:58:05ZengMDPI AGJournal of Personalized Medicine2075-44262021-10-011111111210.3390/jpm11111112Pharmacogenomic Testing and Patient Perception Inform Pain PharmacotherapyFeng-Hua Loh0Brigitte Azzi1Alexander Weingarten2Zvi G. Loewy3Touro College of Pharmacy, New York, NY 10027, USATouro College of Pharmacy, New York, NY 10027, USAComprehensive Pain Associates, Syosset, NY 11791, USATouro College of Pharmacy, New York, NY 10027, USA(1) Background: Chronic pain is one of the most common reasons for individuals to seek medications. Historically, opioids have been the mainstay of chronic pain management. However, in some patient populations, opioids fail to demonstrate therapeutic efficacy, whereas in other populations, opioids may cause toxic effects, even at lower doses. Response to pain medication is affected by many factors, including an individual’s genetic variations. Pharmacogenomic testing has been designed to help achieve optimal treatment outcomes. This study aimed at assessing the impact of CYP2D6 pharmacogenomic testing on physicians’ choice in prescribing chronic pain medications and patient pain control. (2) Methods: This retrospective study reviewed 107 patient charts from a single site pain management center. All 107 patients received pharmacogenomic testing. The outcomes of interest were confirmation that the optimal pain medication is being administered or a change in the chronic pain medication is warranted as a result of the pharmacogenomic testing. The main independent variable was the pharmacogenomic test result. Other independent variables included patient gender, race, and comorbidities. The retrospective study was reviewed and approved by the Touro College and University System IRB, HSIRB1653E. (3) Results: Patients self-reported pain intensity on a scale of 1–10 before and after pharmacogenomic testing. Then, 100% of patients in the retrospective study were tested for their pain pharmacogenomic profile. Of the 107 patients participating in the study, more than 50% had their medications altered as a result of the pharmacogenomic testing. The percentage of patients with intense pain were decreased post-pharmacogenomic testing (5.6%) as compared to pre-pharmacogenomic testing (10.5%). Patients with intense, moderate, and mild pain categories were more likely to receive changes in pain medications. In contrast, patients with severe pain were less likely to receive a change in pain medication. Hispanic ethnicity was associated with a statistically significantly decrease in a pain scale category. Illegal drug abuse was associated with a decrease in pain scale category. Change in medication dose was associated with a decrease in pain scale category. (4) Conclusion: In this retrospective study, implementation of pharmacogenomic testing demonstrated significant benefits to patients with intense pain undergoing treatment.https://www.mdpi.com/2075-4426/11/11/1112painpharmacogenomicspolymorphismpharmacotherapy
spellingShingle Feng-Hua Loh
Brigitte Azzi
Alexander Weingarten
Zvi G. Loewy
Pharmacogenomic Testing and Patient Perception Inform Pain Pharmacotherapy
Journal of Personalized Medicine
pain
pharmacogenomics
polymorphism
pharmacotherapy
title Pharmacogenomic Testing and Patient Perception Inform Pain Pharmacotherapy
title_full Pharmacogenomic Testing and Patient Perception Inform Pain Pharmacotherapy
title_fullStr Pharmacogenomic Testing and Patient Perception Inform Pain Pharmacotherapy
title_full_unstemmed Pharmacogenomic Testing and Patient Perception Inform Pain Pharmacotherapy
title_short Pharmacogenomic Testing and Patient Perception Inform Pain Pharmacotherapy
title_sort pharmacogenomic testing and patient perception inform pain pharmacotherapy
topic pain
pharmacogenomics
polymorphism
pharmacotherapy
url https://www.mdpi.com/2075-4426/11/11/1112
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AT alexanderweingarten pharmacogenomictestingandpatientperceptioninformpainpharmacotherapy
AT zvigloewy pharmacogenomictestingandpatientperceptioninformpainpharmacotherapy