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{
    "pk": 14829,
    "title": "United States Emergency Department Use of Medications with Pharmacogenetic Recommendations",
    "subtitle": null,
    "abstract": "Introduction:\n Emergency departments (ED) use many medications with a range of therapeutic efficacy and potential significant side effects, and many medications have dosage adjustment recommendations based on the patient’s specific genotype. How frequently medications with such pharmaco-genetic recommendations are used in United States (US) EDs has not been studied. \n \nMethods:\n We conducted a cross-sectional analysis of the 2010–2015 National Hospital Ambulatory Medical Care Survey (NHAMCS). We reported the proportion of ED visits in which at least one medication with Clinical Pharmacogenetics Implementation Consortium (CPIC) recommendation of Level A or B evidence was ordered. Secondary comparisons included distributions and 95% confidence intervals of age, gender, race/ethnicity, ED disposition, geographical region, immediacy, and insurance status between all ED visits and those involving a CPIC medication.\nResults:\n From 165,155 entries representing 805,726,000 US ED visits in the 2010–2015 NHAMCS, 148,243,000 ED visits (18.4%) led to orders of CPIC medications. The most common CPIC medication was tramadol (6.3%). Visits involving CPIC medications had higher proportions of patients who were female, had private insurance and self-pay, and were discharged from the ED. They also involved lower proportions of patients with Medicare and Medicaid. \nConclusion:\n Almost one fifth of US ED visits involve a medication with a pharmacogenetic recommendation that may impact the efficacy and toxicity for individual patients. While direct application of genotyping is still in development, it is important for emergency care providers to understand and support this technology given its potential to improve individualized, patient- centered care.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Emergency Departments, pharmacogenomics, medications"
        }
    ],
    "section": "Health Outcomes",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/4wx1n4gf",
    "frozenauthors": [
        {
            "first_name": "Alexander",
            "middle_name": "T.",
            "last_name": "Limkakeng",
            "name_suffix": "",
            "institution": "Duke University School of Medicine, Division of Emergency Medicine, Durham, North Carolina",
            "department": "None"
        },
        {
            "first_name": "Pratik",
            "middle_name": "",
            "last_name": "Manandhar",
            "name_suffix": "",
            "institution": "Duke University School of Medicine, Department of Biostatistics and Bioinformatics, Durham, North Carolina",
            "department": "None"
        },
        {
            "first_name": "Alaatin",
            "middle_name": "",
            "last_name": "Erkanli",
            "name_suffix": "",
            "institution": "Duke University School of Medicine, Department of Biostatistics and Bioinformatics, Durham, North Carolina",
            "department": "None"
        },
        {
            "first_name": "Stephanie",
            "middle_name": "A.",
            "last_name": "Eucker",
            "name_suffix": "",
            "institution": "Duke University School of Medicine, Division of Emergency Medicine, Durham, North Carolina; Duke University School of Medicine, Department of Orthopedics, Durham, North Carolina",
            "department": "None"
        },
        {
            "first_name": "Adam",
            "middle_name": "",
            "last_name": "Root",
            "name_suffix": "",
            "institution": "Duke University Hospital, Department of Pharmacy, Durham, North Carolina",
            "department": "None"
        },
        {
            "first_name": "Deepak",
            "middle_name": "",
            "last_name": "Voora",
            "name_suffix": "",
            "institution": "Duke University School of Medicine, Division of Cardiology, Durham, North Carolina",
            "department": "None"
        }
    ],
    "date_submitted": "2020-12-18T15:37:59+01:00",
    "date_accepted": "2020-12-18T15:37:59+01:00",
    "date_published": "2021-09-24T03:01:55+02:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/14829/galley/7536/download/"
        }
    ]
}