@文章{信息:doi/10.2196/32902，作者=“Tagwerker, Christian and Carias-Marines, Mary Jane and Smith, David J”，标题=“药物基因组学检测在临床疼痛管理中的作用:回顾性研究”，期刊=“JMIRx Med”，年=“2022”，月=“5”，日=“3”，卷=“3”，号=“2”，页=“e32902”，关键词=“药物基因组学”;疼痛管理;药物之间的相互作用;DDI;药房;处方;遗传学;基因组学;药物相互作用;背景:在过去十年中，药物基因组学(PGx)方法用于确定个体化患者治疗的正确药物和剂量的可用性有所增加。 Adoption of the resulting PGx reports in a clinical setting and monitoring of clinical outcomes is a challenging and long-term commitment. Objective: This study summarizes an extended PGx deep sequencing panel intended for medication dosing and prescription guidance newly adopted in a pain management clinic. The primary outcome of this retrospective study reports the number of cases and types of drugs covered, for which PGx data appears to have assisted in optimal drug prescription and dosing. Methods: A PGx panel is described, encompassing 23 genes and 141 single-nucleotide polymorphisms or indels, combined with PGx dosing guidance and drug-gene interaction (DGI) and drug-drug interaction (DDI) reporting to prevent adverse drug reactions (ADRs). During a 2-year period, patients (N=171) were monitored in a pain management clinic. Urine toxicology, PGx reports, and progress notes were studied retrospectively for changes in prescription regimens before and after the PGx report was made available to the provider. An additional algorithm provided DGIs and DDIs to prevent ADRs. Results: Among patient PGx reports with medication lists provided (n=146), 57.5{\%} (n=84) showed one or more moderate and 5.5{\%} (n=8) at least one serious PGx interaction. A total of 96 (65.8{\%}) patients showed at least one moderate and 15.1{\%} (n=22) one or more serious DGIs or DDIs. A significant number of active changes in prescriptions based on the 102 PGx/DGI/DDI report results provided was observed for 85 (83.3{\%}) patients for which a specific drug was either discontinued or switched within the defined drug classes of the report, or a new drug was added. Conclusions: Preventative action was observed for all serious interactions, and only moderate interactions were tolerated for the lack of other alternatives. This study demonstrates the application of an extended PGx panel combined with a customized informational report to prevent ADRs and improve patient care. ", issn="2563-6316", doi="10.2196/32902", url="https://med.jmirx.org/2022/2/e32902", url="https://doi.org/10.2196/32902" }