Optimizing drug outcomes through pharmacogenetics: A case for preemptive genotyping

J. S. Schildcrout, J. C. Denny, E. Bowton, W. Gregg, J. M. Pulley, M. A. Basford, J. D. Cowan, H. Xu, A. H. Ramirez, D. C. Crawford, M. D. Ritchie, J. F. Peterson, D. R. Masys, R. A. Wilke, D. M. Roden

Research output: Contribution to journalArticlepeer-review

156 Scopus citations


Routine integration of genotype data into drug decision making could improve patient safety, particularly if many relevant genetic variants can be assayed simultaneously before prescribing the target drug. The frequency of opportunities for pharmacogenetic prescribing and the potential adverse events (AEs) mitigated are unknown. We examined the frequency with which 56 medications with known outcomes influenced by variant alleles were prescribed in a cohort of 52,942 medical home patients at Vanderbilt University Medical Center (VUMC). Within a 5-year window, we estimated that 64.8% (95% confidence interval (CI): 64.4-65.2%) of individuals were exposed to at least one medication with an established pharmacogenetic association. Using previously published results for six medications with severe, well-characterized, genetically linked AEs, we estimated that 383 events (95% CI, 212-552) could have been prevented with an effective preemptive genotyping program. Our results suggest that multiplexed, preemptive genotyping may represent an efficient alternative approach to current single-use ("reactive") methods and may also improve safety.

Original languageEnglish (US)
Pages (from-to)235-242
Number of pages8
JournalClinical pharmacology and therapeutics
Issue number2
StatePublished - Aug 2012

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)


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