Pharmacogenetic testing benefits MD’s and Patients
Jan 16, 2017
Genetic testing is not a new concept and has been used as a medical tool for decades to allow the medical community to take a deeper look into the human body to make a myriad of determinations.
Newborn screening, diagnostic and carrier testing, preimplantation genetic diagnosis, prenatal diagnosis and predictive and presymptomatic testing are just a few reasons why chromosomes, proteins and metabolites are investigated. Other reasons could be for paternity tests, genealogy, forensics and more.
But a relatively new genetic testing, at least one approved by the Federal Drug Administration, is helping physicians provide better care for their patients by understanding how medications break down in their bodies.
The Olney Family Clinic – an extension of Hamilton Hospital in Olney – is now employing pharmacogenetic testing through GeneMed Management as another tool in their family practitioners’ tool boxes to manage their patients’ health by getting them on the most effective medications and possibly removing those that are ineffective or contradictory to others.
Dr. Jeremy Johnson is one of the family physicians at the clinic who is using this approach to patient care in rural Texas. He said they have screened about 50 patients, and about half of those needed to have their medications adjusted for the most effective treatment.
“It’s going to be a good thing for patients that I’ve kind of hit a road block on,” he said. “Let’s do this test and make sure that we’re metabolizing your medicine right, and it will give me another tool in my tool box.”
Dr. Jeremy Johnson, of Olney Hamilton Hospital, talks with John Ingle, the business editor for the Wichita Falls Times Record News, about the benefits of pharmacogenetic testing. The testing uses a patient’s DNA to help identify risks of adverse reactions to medications and determine the most effective medications and dosages. (Photo: Torin Halsey/Times Record News, AP)
Johnson said it was in the 1990s that researchers discovered what genes are responsible for helping break down medications in the body and that there are some genes that cause a mutation in a person’s genetic structure that doesn’t allow for the most efficient metabolic process, rendering the medication ineffective for a patient. He said some mutations can cause a medication to break down too quickly before it can reach its active stage, or the medication won’t metabolize enough to reach that state.
The screening, which consists of a review of medications, medical history and a mouth swab, will compare the results with the medications prescribed to a patient and advise which ones are effective, not quite as effective or won’t work at all. The results also provide dosage guidance, flagging those medications with are nonresponsive and explain why others are meeting the desired results.
“If you’ve got a mutation in one of your genes, your system is not working like it should,” Johnson said. “This Genemed (testing) shows us where people actually have these mutations. It’s really crazy, but there’s a lot of it out there. We’re (humans) not perfect, and as we get older there’s a lot of mutations that happen – our genetic structures actually change, our telomeres shorten, which is part of our chromosomes – so, that ends up making us change.”
Johnson said the reason some medications aren’t working – not necessarily always, but sometimes – is because the genetic structure has changed, preventing a medication for one reason or another from reaching its active stage.
Olney Hamilton Hospital LVN Angela Moreno takes the vital signs of John Ingle, business editor for the Wichita Falls Times Record News, for a story on DNA sampling and genetic testing for prescribing more effective medications and dosages. (Photo: Torin Halsey/Times Record News, AP)
Mike Huff, CEO of Hamilton Hospital in Olney, said they decided about six months ago that the genetic screening was a service they wanted to add for their patients as well as for their doctors to continue providing quality health care to the Northern Young County town and the surrounding area. He said their pharmacy contractor told hospital leadership of the GeneMed Management and that they were providing the service in other rural areas such as Brady, Texas.
He said the pharmacogenetic testing had typically been relegated to larger facilities or teaching hospitals, but now the specimens could be collected at smaller hospitals and clinics and submitting to a central laboratory for testing and results.
Huff said he arranged a presentation for Hamilton Hospital’s medical staff, and they were able to ask the experts questions about the screening and its usefulness. The physicians decided if that was something they could do in Olney, then they should try it.
“The win-win is for the patients, really,” he said. “If we can provide a service in our community and the patients don’t have to drive to Dallas or somewhere else to get the service and we’re able to provide it here, then they get to stay home and that’s a win for them.
“We get to provide the service, and that’s a win for us. It’s good for everyone all around.”
The service is currently offered only at Olney Family Clinic unless a physician orders the screening for a patient admitted to Hamilton Hospital. It could soon be offered at Archer Family Clinic in Archer City.
Huff said the test is fairly expensive, but it is something that insurance is covering. He said, as with all tests and treatments, the affordability will depend on the insurance.
Those interested in the screening can call Olney Family Clinic at 940-564-3546 and make an appointment with a provider. People do not have to be patients of a provider there, but they will be required to fill out registration paperwork.
Follow John Ingle on Twitter at @inglejohn1973.
Business/metro editor John Ingle underwent the screening process at Olney Family Clinic on Wednesday as part of the story about pharmacogentic testing being done in the small Young County community of Olney.
Test results should be available in about two weeks, at which time he will have a follow-up with the clinic to go over the findings. He will also report on those results.