Additionally, this study may serve as a model for the use of geospatial analysis in PGx implementation. Patients with poor geographic access, as determined using the two-step floating catchment area method, use a higher proportion of PGx drugs. WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?.Medically underserved patients may benefit from PGx testing, but little is known about how PGx drugs are currently used in these populations.Īre patients with barriers to health care access prescribed more drugs with published PGx guidelines? WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?ĭrugs with pharmacogenetic (PGx) testing guidelines are often off patent and cheaper than newer alternatives.Overall, these results suggest that improved geographic access to PGx testing may allow prescribers to make more efficient use of limited opportunities to optimize therapy for drugs with PGx testing guidelines. Compared to Q1, Black patients with Q4 access scores were disproportionately affected and had fewer encounters (IRR 0.76, 95% CI 0.7–0.82) and a higher proportion of PGx drugs (IRR 1.26, 95% CI 1.13–1.41), creating further disparity. We detected significant interactions between Black race and access score. After correcting for number of unique drugs, patients in low-access areas were prescribed a greater proportion of PGx guideline drugs (IRR 1.08, 95% CI 1.04–1.13). Comparing the poorest (Q4) and greatest (Q1) access score quartiles, poor geographic access was significantly associated with fewer prescriber encounters (incidence rate ratio 0.88, 95% confidence interval 0.86–0.91), fewer total unique drugs (IRR 0.92, 95% CI 0.9–0.95), and fewer PGx guideline drugs (IRR 0.94, 95% CI 0.9–0.99). We used electronic health record data from 67,753 University of Florida Health patients, geographic access scores calculated via the 2-step floating catchment area method, and a composite measure of socioeconomic status. The objective of this study was to identify patient populations with poor health care access and assess prescribing trends for drugs with published PGx testing guidelines. Pharmacogenetic (PGx) testing may be particularly beneficial in medically underserved populations by reducing the number of appointments required to optimize drug therapy and increasing the effectiveness of less expensive off-patent drugs.
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