Methods and implementation of a pediatric asthma pharmacogenomic study in the emergency department setting. Issue 9 (December 2020)

• Record Type: Journal Article
• Authors: Fishe, Jennifer N.; Higley, Rebecca K.; Casey, Deirdre; Hogans, Lamont; Wylie, Todd W.; Hendry, Phyllis L.; Henson, Morgan; Bertrand, Andrew; Blake, Kathryn V.
• Is Part Of: Pharmaocogenetics and genomics. Volume 30:Issue 9(2020)
• Publication Date: 2020-12
• Subjects: asthma -- bronchodilator response -- emergency department -- pediatric -- pharmacogenomics; Pharmacogenetics -- Periodicals; Pharmacogenomics -- Periodicals; Genetic toxicology -- Periodicals; Biomedical genetics -- Periodicals; 615.7
• DOI: 10.1097/FPC.0000000000000414
• Languages: English
• ISSNs: 1744-6872

Abstract

Abstract : Objectives: The emergency department (ED) is a challenging setting to conduct pharmacogenomic studies and integrate that data into fast-paced and potentially life-saving treatment decisions. Therefore, our objective is to present the methods and feasibility of a pilot pharmacogenomic study set in the ED that measured pediatric bronchodilator response (BDR) during acute asthma exacerbations. Methods: This is an exploratory pilot study that collected buccal swabs for DNA and measured BDR during ED encounters for pediatric asthma exacerbations. We evaluated the study's feasibility with a qualitative analysis of ED provider surveys and quantitatively by the proportion of eligible patients enrolled. Results: We enrolled 59 out of 90 patients (65%) that were identified and considered eligible during a 5-month period (target enrollment 60 patients over 12 months). The median patient age was 7 years (interquartile range 4–9 years), 61% ( N = 36) were male, and 92% ( N = 54) were African American. Quality DNA collection was successful for all 59 patients. The ED provider survey response rate was 100%. Most ED providers reported that the study did not impact their workflow (98% of physicians, 88% of nurses, and 90% of respiratory therapists). ED providers did report difficulties with spirometry in the younger age group. Conclusions: Pharmacogenomic studies can be conducted in the ED setting, and enroll a younger patient population with a high proportion of minority participants. By disseminating this study's methods and feasibility analysis, we aim to increase interest in pharmacogenomic studies set in the ED and aimed toward future ED-based pharmacogenomic decision-making.