More than a quarter of patients taking antidepressants, statins, or proton pump inhibitors (PPIs) have been advised to alter their prescriptions following pharmacogenetic testing, according to a pilot study.
The study, part of The Pharmacogenetics Roll Out – Gauging Response to Service programme, or PROGRESS for short, was launched in June 2023 across a select number of GP surgeries in the North West of England.
So far, over 430 patients have been recruited, with the initiative aimed at evaluating the feasibility of a broader NHS diagnostic service that identifies genetic variations influencing drug response.
Process
Patients provide a saliva sample, which is analysed at the NHS North West Genomic Laboratory Hub. The results are sent back to the primary care team within 7 to 10 working days, enabling clinicians to make more informed prescribing decisions.
Initially, the study invited patients taking selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, statins, or PPIs. Later, codeine and tramadol were added to the trial protocol to broaden its scope.
Jessica Keen, pharmacy lead at NHS North West Genomic Medicine Service Alliance said: "The majority of participants were prescribed either statins or SSRIs, reflecting both the high prescription rates of these medications in general practice and the value of pharmacogenomic testing in these cases."
Participants
The study recruited a diverse group of patients. While the majority were white British, over 20% of participants came from other ethnic backgrounds, reflective of local populations. Participant ages ranged from 18 to 92 years, with the predominant age groups being 20-24 and 65-69 years.
Feedback from both clinicians and patients has been overwhelmingly positive. Participants and healthcare professionals expressed enthusiasm about the study's potential to improve clinical care.
There were challenges associated with conducting research in busy primary care settings, particularly in relation to additional administrative tasks such as obtaining consent and entering data. To address this the study introduced an electronic consenting (eConsenting) system, allowing patients to participate remotely. This process also enables patients to send saliva samples directly to the laboratory, reducing delays.
Project expansion
The programme is now entering its second phase, which involves scaling up recruitment and expanding to more sites across England. While phase one focused on validating the testing technology, phase two aims to enhance the integration of pharmacogenomic results into clinical workflows.
A key development in this phase is the introduction of ProgressRx, an information solution that integrates pharmacogenomic test results and prescribing guidance directly into patients’ electronic health records which will streamline the process for clinicians, ensuring that pharmacogenomic information can be easily accessed and utilised during patient care.
Potential in the future
Jessica added "The potential of the PROGRESS programme is the optimisation of prescribing and enhanced patient outcomes. The study will also identify barriers to the national rollout of pharmacogenomic services and propose solutions to overcome them.
“Success from the study would demonstrate the benefit of introducing pharmacogenomic testing into primary care and show that national implementation is both feasible and impactful."
For more information on the PROGRESS research study, please visit our 'Spotlight' page.