Multidisciplinary Consulting Team for Complicated Cases of Neurodevelopmental and Neurobehavioral Disorders: Assessing the Opportunities and Challenges of Integrating Pharmacogenomics into a Team Setting
Neurodevelopmental disorders have steadily increased in incidence in the United States. Over the past decade, there have been significant changes in clinical diagnoses and treatments some of which are due to the increasing adoption of pharmacogenomics (PGx) by clinicians. In this pilot study, a mult...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/4/599 |
| _version_ | 1797434462613536768 |
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| author | Pritmohinder S. Gill Amanda L. Elchynski Patricia A. Porter-Gill Bradley G. Goodson Mary Ann Scott Damon Lipinski Amy Seay Christina Kehn Tonya Balmakund G. Bradley Schaefer |
| author_facet | Pritmohinder S. Gill Amanda L. Elchynski Patricia A. Porter-Gill Bradley G. Goodson Mary Ann Scott Damon Lipinski Amy Seay Christina Kehn Tonya Balmakund G. Bradley Schaefer |
| author_sort | Pritmohinder S. Gill |
| collection | DOAJ |
| description | Neurodevelopmental disorders have steadily increased in incidence in the United States. Over the past decade, there have been significant changes in clinical diagnoses and treatments some of which are due to the increasing adoption of pharmacogenomics (PGx) by clinicians. In this pilot study, a multidisciplinary team at the Arkansas Children’s Hospital North West consulted on 27 patients referred for difficult-to-manage neurodevelopmental and/or neurobehavioral disorders. The 27 patients were evaluated by the team using records review, team discussion, and pharmacogenetic testing. OneOme RightMed<sup>®</sup> (Minneapolis, MN, USA) and the Arkansas Children’s Hospital comprehensive PGx test were used for drug prescribing guidance. Of the 27 patients’ predicted phenotypes, the normal metabolizer was 11 (40.8%) for CYP2C19 and 16 (59.3%) for CYP2D6. For the neurodevelopmental disorders, the most common comorbid conditions included attention-deficit hyperactivity disorder (66.7%), anxiety disorder (59.3%), and autism (40.7%). Following the team assessment and PGx testing, 66.7% of the patients had actionable medication recommendations. This included continuing current therapy, suggesting an appropriate alternative medication, starting a new therapy, or adding adjunct therapy (based on their current medication use). Moreover, 25.9% of patients phenoconverted to a CYP2D6 poor metabolizer. This retrospective chart review pilot study highlights the value of a multidisciplinary treatment approach to deliver precision healthcare by improving physician clinical decisions and potentially impacting patient outcomes. It also shows the feasibility to implement PGx testing in neurodevelopmental/neurobehavioral disorders. |
| first_indexed | 2024-03-09T10:33:36Z |
| format | Article |
| id | doaj.art-ebb8281eff514335a3d43fa1501502f6 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T10:33:36Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-ebb8281eff514335a3d43fa1501502f62023-12-01T21:08:56ZengMDPI AGJournal of Personalized Medicine2075-44262022-04-0112459910.3390/jpm12040599Multidisciplinary Consulting Team for Complicated Cases of Neurodevelopmental and Neurobehavioral Disorders: Assessing the Opportunities and Challenges of Integrating Pharmacogenomics into a Team SettingPritmohinder S. Gill0Amanda L. Elchynski1Patricia A. Porter-Gill2Bradley G. Goodson3Mary Ann Scott4Damon Lipinski5Amy Seay6Christina Kehn7Tonya Balmakund8G. Bradley Schaefer9Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USAArkansas Children’s Hospital, 1 Children’s Way, Little Rock, AR 72202, USAArkansas Children’s Research Institute, Little Rock, AR 72202, USASchmieding Developmental Center, Springdale, AR 72762, USASchmieding Developmental Center, Springdale, AR 72762, USASchmieding Developmental Center, Springdale, AR 72762, USASchmieding Developmental Center, Springdale, AR 72762, USASchmieding Developmental Center, Springdale, AR 72762, USADepartment of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USADepartment of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USANeurodevelopmental disorders have steadily increased in incidence in the United States. Over the past decade, there have been significant changes in clinical diagnoses and treatments some of which are due to the increasing adoption of pharmacogenomics (PGx) by clinicians. In this pilot study, a multidisciplinary team at the Arkansas Children’s Hospital North West consulted on 27 patients referred for difficult-to-manage neurodevelopmental and/or neurobehavioral disorders. The 27 patients were evaluated by the team using records review, team discussion, and pharmacogenetic testing. OneOme RightMed<sup>®</sup> (Minneapolis, MN, USA) and the Arkansas Children’s Hospital comprehensive PGx test were used for drug prescribing guidance. Of the 27 patients’ predicted phenotypes, the normal metabolizer was 11 (40.8%) for CYP2C19 and 16 (59.3%) for CYP2D6. For the neurodevelopmental disorders, the most common comorbid conditions included attention-deficit hyperactivity disorder (66.7%), anxiety disorder (59.3%), and autism (40.7%). Following the team assessment and PGx testing, 66.7% of the patients had actionable medication recommendations. This included continuing current therapy, suggesting an appropriate alternative medication, starting a new therapy, or adding adjunct therapy (based on their current medication use). Moreover, 25.9% of patients phenoconverted to a CYP2D6 poor metabolizer. This retrospective chart review pilot study highlights the value of a multidisciplinary treatment approach to deliver precision healthcare by improving physician clinical decisions and potentially impacting patient outcomes. It also shows the feasibility to implement PGx testing in neurodevelopmental/neurobehavioral disorders.https://www.mdpi.com/2075-4426/12/4/599neurodevelopmental disordersautism spectrum disorderADHDpharmacogenomicsCYP2D6CYP2C19 |
| spellingShingle | Pritmohinder S. Gill Amanda L. Elchynski Patricia A. Porter-Gill Bradley G. Goodson Mary Ann Scott Damon Lipinski Amy Seay Christina Kehn Tonya Balmakund G. Bradley Schaefer Multidisciplinary Consulting Team for Complicated Cases of Neurodevelopmental and Neurobehavioral Disorders: Assessing the Opportunities and Challenges of Integrating Pharmacogenomics into a Team Setting Journal of Personalized Medicine neurodevelopmental disorders autism spectrum disorder ADHD pharmacogenomics CYP2D6 CYP2C19 |
| title | Multidisciplinary Consulting Team for Complicated Cases of Neurodevelopmental and Neurobehavioral Disorders: Assessing the Opportunities and Challenges of Integrating Pharmacogenomics into a Team Setting |
| title_full | Multidisciplinary Consulting Team for Complicated Cases of Neurodevelopmental and Neurobehavioral Disorders: Assessing the Opportunities and Challenges of Integrating Pharmacogenomics into a Team Setting |
| title_fullStr | Multidisciplinary Consulting Team for Complicated Cases of Neurodevelopmental and Neurobehavioral Disorders: Assessing the Opportunities and Challenges of Integrating Pharmacogenomics into a Team Setting |
| title_full_unstemmed | Multidisciplinary Consulting Team for Complicated Cases of Neurodevelopmental and Neurobehavioral Disorders: Assessing the Opportunities and Challenges of Integrating Pharmacogenomics into a Team Setting |
| title_short | Multidisciplinary Consulting Team for Complicated Cases of Neurodevelopmental and Neurobehavioral Disorders: Assessing the Opportunities and Challenges of Integrating Pharmacogenomics into a Team Setting |
| title_sort | multidisciplinary consulting team for complicated cases of neurodevelopmental and neurobehavioral disorders assessing the opportunities and challenges of integrating pharmacogenomics into a team setting |
| topic | neurodevelopmental disorders autism spectrum disorder ADHD pharmacogenomics CYP2D6 CYP2C19 |
| url | https://www.mdpi.com/2075-4426/12/4/599 |
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