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As an emerging health technology, pharmacogenetic (PGx) testing has the capacity to improve medication therapy. However, implementation in medically underserved populations (MUPs) remains limited, which has the potential to increase healthcare disparities. While there is no single accepted definition for MUPs, demographic, socioeconomic, cultural, and geographic factors can lead to reduced access to healthcare, which contributes to disparate health outcomes in these populations. In the case of PGx testing, as MUPs have an increased risk of adverse drug events, have lower numbers of healthcare encounters, and are prescribed more medications which can be guided by PGx testing, additional benefits from PGx testing may occur in MUPs. Study of the acceptability and perceptions of PGx testing in MUPs, as reported in literature, provides support for the development of successful PGx testing implementations. Additionally, a few limited pilot PGx testing implementations in MUPs have assessed feasibility. However, further studies establishing the feasibility and effectiveness of PGx testing implementations in MUPs will enable more widespread PGx testing in those who are medically underserved. Thus, this narrative review explores the impact of medical underservice on health, PGx testing's potential impact on MUPs, and the research and early clinical implementations of PGx in MUPs.
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http://dx.doi.org/10.1080/14622416.2025.2490461 | DOI Listing |
J Med Internet Res
September 2025
Artificial Intelligence Center, China Medical University Hospital, 2, Yude Road, Taichung, 404327, Taiwan, 886 4-22052121.
Background: The effective implementation of personalized pharmacogenomics (PGx) requires the integration of released clinical guidelines into decision support systems to facilitate clinical applications. Large language models (LLMs) can be valuable tools for automating information extraction and updates.
Objective: This study aimed to assess the effectiveness of repeated cross-comparisons and an agreement-threshold strategy in 2 advanced LLMs as supportive tools for updating information.
J Clin Psychopharmacol
September 2025
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA.
Purpose/background: Multiple meta-analyses have suggested that pharmacogenomic (PGx) testing may be a valuable tool to improve clinical outcomes for patients with major depressive disorder (MDD) who have failed at least one treatment. However, these meta-analyses included studies with different PGx tests and different trial designs, which produce uncertainty when interpreting results. To investigate the clinical utility of a single weighted multigene PGx test, a meta-analysis was performed for prospective studies utilizing this PGx test in adult patients with MDD.
View Article and Find Full Text PDFPharmaceuticals (Basel)
August 2025
Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
Medication discontinuation attributable to adverse drug reactions (ADRs) and/or inefficacy remains a concern of psychotropic medications among children and adolescents. Pharmacogenetic (PGx) testing has been proposed to individualize treatment, although its utility remains uncertain. We retrospectively evaluated whether PGx testing of two key metabolism genes (i.
View Article and Find Full Text PDFBMJ Open
August 2025
Department of Family Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada.
Objectives: Many patients with major depressive disorder must try multiple antidepressants before they identify a drug that is both effective and tolerable. Pharmacogenomic (PGx) testing may provide clinicians with guidance around medication choice based on a patient's drug response-related genetic variants. However, this technology is not routinely used in clinical care in Canada, and the views of key actors in the implementation process are largely unknown.
View Article and Find Full Text PDFJ Am Pharm Assoc (2003)
August 2025
Sanford Imagenetics, Sanford Health, Sioux Falls, South Dakota, USA; Department of Internal Medicine, University of South Dakota School of Medicine, Vermillion, South Dakota, USA.
Background: CYP2D6 affects metabolism of several opioids; however, the clinical impact of genetic variants on efficacy has limited evidence in large patient populations.
Objective: This study aims to assess the impact of CYP2D6 phenotype on pain response in an elective pharmacogenomic (PGx) screening population prescribed opioids.
Methods: A retrospective review was conducted on hospitalized patients with CYP2D6 genotyping, prescribed either codeine, tramadol, hydrocodone, or oxycodone within 24 months prior to PGx testing and through 36 months after results.