Clay Bullard on DNA Testing in Long Term Care and Assisted Living Communities
For more information on how you can implement this medication management tool in your senior community, contact: PGx Medical, firstname.lastname@example.org or call 405-509-5112.
Jim McWhirter talks about how pharmacogenetics can help address key clinical concerns such as falls, dementia, pain, sleep and more. For more information, contact PGx Medical at 405-509-5112 or email@example.com
Below are testimonials we’ve received from doctors, directors of nursing, pharmacists and government officials regarding our medication management program, via pharmacogenetic testing.
PGx Medical is the trusted and experienced resource for the implementation of pharmacogenetics in the field of aging services.
Pharmacogenetics aligns current and future medication with each persons unique genetic profile.
As we work alongside long-term care communities, clinics and pharmacies, we have the privilege of receiving success stories on how pharmacogenetics has impacted residents, patients, family and staff.
We recently implemented pharmacogenetic testing and feel it is very easy to administer. The test results are helpful when dosing or treating our residents, and saves our staff time and frustration as providers by making sure our patients are on the correct medications. On average, approximately 90% of our patients need a dose change, med change or to discontinue a medication after testing.
We had one patient we had tried so many SSRI/SNRIs and after her PGx test, we were able to find the right medication regimen and now she feels great! We would recommend this program to anyone who has patients on multiple medications. ~Rachel Moore, PA-C~
I have found the pharmacogenetic test to be very useful for patients in my clinic practice as well as my nursing home patients. It is quick to use! In fact, my nurses do all of the work and then they go thru the results and alert me of the medications that are less likely to work for those patients. It takes no time for me at all! The paperwork is very minimal and nurses can fill it out. It takes less than a minute to swab the inside of both cheeks. Then it gets mailed off and the results come back in just a few days.
I had a patient in my clinic that had seen multiple doctors, a psychiatrist and several counselors for her depression. She had tried many medications to help her depression but she complained that none of them made her feel better. We did a pharmacogenetic test and found out that the patient had a gene mutation that kept ALL of the antidepressants from working. No wonder she never felt better with the medications! From the test results we found some alternative medications that could be used to treat her depression. She was so relieved that there was a really good reason for the previous anti-depressants not to work.
I had a patient who had shoulder surgery who kept complaining that the Hydrocodone did not help his pain. The Naproxen actually did better in controlling his pain. We did a pharmacogenetic test and found out that Hydrocodone does not work well for his pain but Naproxen works best. This is helpful information if he ever has to use pain medication again.
I had a patient who complained that his pain meds were not working at all and would ask for more and more. I suspected he was a drug seeker but could not prove it. We did a pharmacogenetic test on him and discovered ALL of the narcotics work well for him. We now know he is a drug seeker and treat him appropriately.
The PGx Medical Pharmacogenetic test is helpful if a patient is not responding to a medication as well as we think they should. This helps us chose appropriate medications that are more likely to work and avoid those that may cause problems for the patient. It is very helpful with resistant depression, psychosis and ADHD medication failures. I am even starting to use the testing first before prescribing any medication. Patients love the testing because we can avoid the medications that are not likely to work or those that could cause adverse reactions; they get on the right medications quicker with less trial and error. Insurances like it because it saves them money by getting quicker results without multiple medication changes.
Nursing Home surveyors encourage nursing homes to use the pharmacogenetic testing on patients to try to keep patients off of multiple medications and to use those that work well. It also decreases the adverse reactions and helps keep patients off of anti-psychotics or at least on minimal doses of anti-psychotics. ~ Dr. Jami Benton ~
“The PGx Medical pharmacogenetic test program has yielded great results at our home. It is now a fully implemented tool my clinical staff reviews with all of our residents. The reports are easy to understand with clear actionable recommendations. I am thankful we were allowed to be the first to have such a tool to use here at our home. Each resident deserves our very best.”~Treva, MD~
“Seems too good to be true, but always produces positive results. I utilize the testing daily now in my practice. For Geriatrics provides the tool for easy medication adjustments. The reports are not complex. Very beneficial for identifying the effectiveness of analgesics in residents who are unable to communicate. There are residents that we may have labeled as ‘drug seekers’, and when the DNA test report is returned we discover that the analgesic they were prescribed is not being metabolized in their body and they are getting no relief from their pain. So they have legitimate pain and the analgesic has not been effective in reducing their pain. This test only has to be performed on each resident one time in their life. That makes it very cost effective. And the reimbursement process has been very easy. The families love it! It tells them exactly what their loved one metabolizes and what is best for them”. The DNA Test results give confidence to the residents that they are being prescribed the correct medications. Yes, would highly recommend this program! CMS should mandate the test for all residents on Antipsychotics!” ~Dr. Mike M, Long Term Care Physician~
“It is important to me to ensure that each of our veterans in all of our State VA homes are cared for on an individual basis. I was excited to learn of the potential the PGx Medical Pharmacogenetic Program offered and I brought it forward to our administrative and clinical teams, as it seemed to be a ‘no brainer’ for our homes to implement. I’ve heard nothing but positive results and praises of both the Program and PGx Medical.” ~Maj Gen (ret) Secretary of Military and Veterans Affairs~
“This DNA Testing has been a Win-Win for both the residents and families! By utilizing the DNA test results we know exactly which medication is effective for the residents. It is a tremendous cost saver on medications. Not all people that we think are ‘pain seekers’ really are. We had one resident that kept begging for more and more pain meds. We did the DNA Swab Test on her and the test revealed that she was metabolizing zero percent of the pain medication. So she was truly in pain. We are such Believers in this program! It is a wonderful Marketing Tool! We can advertise that we provide the best care possible for residents on these medications!”~Brenda W. Clinical Manager~
“I was privileged to introduce the PGx Medical Pharmacogenetic Testing Program to the Oklahoma Department of Veterans Affairs. As a State Representative, I felt this program was in the best interest of each of our Veterans living in the seven ODVA homes, and to those who are in the homes caring for and assisting them everyday. This program has been exceptional and has produced wonderful results while helping the homes practice a level of personalized care that was previously unattainable. The program has also been clinically and economically beneficial to veterans living in homes.”~State Representative~
“I perform about 20 of the DNA Tests a week. The results are a tremendous help in my practice. The DNA Report provides an objective list to choose from to help my patients. Not knowing the metabolic profile of the patients increases the risk of side effects. It is hit and miss without the test. There is no trial and error period when you use the DNA swab testing. It allows me to select from a list of medications that will help my patients. I recommend this program to many other Doctors and patients. It gives you an individualized report with objective information to correctly order the right medication.”~Dr. Timothy B, Pain Management Specialist~
“We initiated this DNA Testing program in response to the CMS Directive to reduce our Antipsychotic usage. Through the metabolic reports, we have identified that residents were receiving antipsychotics that were actually adverse for them. These residents have shown a marked improvement in abilities and a reduction in side effects. The residents are doing so much better now that they are off these medications. The Family members are very excited about the results. All the medication changes have been positive. When the swab reports come back we have been amazed. We then understand why the residents have been exhibiting behaviors and mood swings. This program is very individualized. It has positive results for everyone, but first and foremost the residents. Our Administrator Markets this DNA Testing as a great program for our residents and the facilities. We have multiple Physicians that see our residents. Some of the Physicians were skeptical at first, but now they are really happy with the results. When we had our Survey, we had signed up with AssureRx but had not put the program into place. The Surveyors asked that we write a letter for them to take back to their Office about out Pending DNA Antipsychotic Program. They were so interested that the Surveyor called back and asked if we would fax them copies of the results. The Surveyor stated their Supervisors were very impressed with the individualized data provided.”~Jennifer H., Director of Nursing~
“The PGx Pharmacogenetic Test was easy for us to see the clinical value it offers, even before implemented. The implementation process that PGx offered was very simple, with very little interruption to our staff. As a pharmacist, the information is extremely valuable on my monthly med reviews and for all new residents upon admission. It helps address the issues of polypharmacy, unnecessary medications and more importantly is another tool to help assure that our residents are getting the best therapy for them. It is a great tool for any pharmacist to have.”~Valarie, DHP~
For more information on how you can implement pharmacogenetics into your community, clinic or pharmacy, contact us at:
Are the medications you’re taking the right ones for you?
Some medications have the “placebo” effect. A placebo is anything that seems to be a “real” medical treatment — but isn’t. It could be a pill, a shot, or some other type of “fake” treatment. Many people are on medications their body doesn’t even have the ability to metabolize. So in other words, it has the “placebo effect” because they are receiving no therapy from this drug and it could be costly. Or worse, you could be on a medication that is not right for your genetic make-up, or may interact with another medication you are taking. This can cause an adverse drug reaction. Unfortunately, ADRs are one of the leading cause of death in the U.S. with over 120,000 people dying each year.
Now there is a simple cheek swab that can help identify how your genes affect your bodies response to medications. Pharmacogenetic tests look for changes or variants in your genes that may determine whether a medication is effective for you or whether you may have side effects to a specific medication.
Some indications for use are:
- People who have a diagnosis of depression or bipolar disorder
- Current medication regimen includes use of antipsychotic medication
- Current medication regimen has five or more medications
- Behaviors – Aggressive or disruptive behaviors unresolved by current medication regimen
- Uncontrolled pain
- History of falls
Studies have shown that incorporating genetic factors into the medication prescribing process can improve efficacy and reduce adverse drug effects.
For more information on implementing pharmacogenetics into your LTC community, or to schedule a free educational webinar on pharmacogenetics, contact PGx Medical at firstname.lastname@example.org or 405-509-5112.
As we wind down our week and start to prepare for the Thanksgiving holiday, we want to say how very thankful we are for the many men and women who spend countless hours caring for our elderly. Many of the residents in long term care communities don’t have family to spend the holidays with and over the years, we have witnessed the love and generosity of LTC staff who spend it with them and make them feel special. Words cannot express how grateful we are to partner with these caregivers. During Thanksgiving and throughout the year, we want to publicly say thank you. If you see a caregiver, whether on staff, a family member or friend, be sure and stop and tell them how much they are appreciated.
As a pharmacy consultant with over 20 years of experience and now nursing home owner, I understand that medications and their side effects can critically impact a patients’ care. To aid physicians in their management and choice of medications for various disease states, I have been utilizing pharmacogenetics testing and it allows me to recommend proper medication therapy more quickly and accurately. The tool from PGx Medical replaces the “trial and error” process consultants cannot afford in a nursing home setting.
I have numerous stories on how a pharmacogenetic (PGx) test report impacted my dosage recommendation or regimen changes. However, small adjustments in dosage or selection of a new pharmaceutical agent with guidance from the PGx report, have lead me to now select medications that can be properly metabolized. Where in the past, I would have just gone to the next drug and hoped for a better outcome.
Below are three case studies I have written:
Case Study #1 – [88 year old female Alzheimer patient that was on Aricept, Namenda and Zyprexa because she was frequently falling]. After getting the pharmacogenetics (PGx) test report, we determined she needed a few med changes based upon her genetic profile. There were certain mutations within her system that were not allowing the medication to provide therapy. With the physician’s approval, we immediately transitioned her to a different drug, Geodon. She responded very well to this medication. Now, we have even been able to reduce her dosage of Geodon and she has not fallen since. This is a great outcome as she is on a lower dosage of medication than she was prior to us using the pharmacogenetics test results.
Case Study #2 – [Male patient, multiple med, pain regimen not providing therapy]. This patient was on Lortab, Asprin and an NSAID for several months. Patient continued to complain of strong pain and medication dosages were increased with no effectiveness in pain reduction. Upon requesting a pharmacogenetic test, patient was placed on Dilaudid. Once we reviewed the test results, we were able to lower his dose of Dilaudid, twice daily while continuing with Asprin. Before the test he was taking Lortab, Asprin and an NSAID. We reduced the patients’ pain medications by 50% and he is doing much better. In reducing the medications by 50% we are also helping to eliminate many of the complications often associated with heavy dosages and large regimens of pain medications. We were also able to reduce the cost of treatment to medicare for this patient.
Case Study #3 – [Male LTC resident on multiple medications]. This patient was only on Allopurinol and was then prescribed Lipitor and had a reaction. They thought his reaction was more of a psychotic reaction so they prescribed him Geodon. The patient had a severe reaction and tried to strangle his father. He was then admitted to a Psych Hospital. We then ordered a pharmacogenetics test to determine if his body could even metabolize the medications. By the enzymes we found, the Geodon or any of the new atypical drugs weren’t going to work for him. So we put him on Thorazine and got him calmed down. We then started reducing the Thorazine and now the patient is back on Allopurinol for gout and that is the only prescription medication he is taking. Great outcome!
Previously, without the PGx testing results to guide us, this change may have taken several different methods and a longer time frame to achieve results. It was very reassuring and validating to me that we were able to intervene on a much quicker basis and helped, which is a benefit to the clinical team and the medical director.
Educating the clinical team and medical directors at the facility on the value this tool provides is crucial, as there is no out of pocket costs for residents covered by medicare (and medicaid in select states). It’s important to reassure residents and family members that the medications they are taking are the most appropriate and able to provide proper therapy. A less medicated, cognizant, mobile resident allows for the home to be more efficient and profitable.
For more information on pharmacogenetics testing, contact PGx Medical at email@example.com or 405-509-5112
Today is World Mental Health Day. The goal is to raise awareness about mental health around the world.
In the U.S. about 1 in 5 adults experience mental illness annually.
According to the National Alliance on Mental Health, about 1 in 25 struggle with a serious mental illness.
Below are statistics on how mental health issues affect Americans:
- 1 in 5 (or 43.8 million) adults experience mental illness in a given year.
- 1 in 25 (or 10 million) adults experience a serious mental illness.
- 1 in 100 (or 2.4 million) live with schizophrenia.
- 2.6% (or 6.1 million) of Americans have bipolar disorder.
- 6.9% (or 16 million) suffer from severe depression.
- 18.1% (or 42 million) live with an anxiety disorder.
- 90% of those who die by suicide have an underlying mental illness.
- Only 41% of adults with a mental health condition received help and less than 50% of children 8-15 received mental health services.
- Only 36.9% of those suffering from anxiety receive treatment.
- Less than 20% of Americans with moderate depressive symptoms sought help from a medical professional.
- And 4% of young adults with self-reported mental health needs forego care.
While the statistics might seem discouraging, there are a number of ways to get help if you or a loved one is struggling with a mental health condition.
Medication can be an important part of the treatment of a mental illness, but finding the right medication at the right dose, for each individual, can take time and may cause harmful side effects.
In The Mental Health Clinician, it states over the past 3 decades, new psychotropic medications have been developed in hopes of improving outcomes such as medication adherence, tolerability, safety, and efficacy. A motivating factor for this has been consistently low reported remission rates in mood disorders with first-line treatment options.
According to the online publication, approximately 40% of treated patients will experience complete remission. In an effort to improve outcomes, mental health pharmacogenomics may play a role in improving outcomes by enhancing decision making in medication selection and treatment strategy. With improved access to genetic testing, future goals within mental health should include providers maintaining a well-rounded understanding of pharmacodynamic and pharmacokinetic properties.
Pharmacogenetics and Mental Health:
Pharmacogenetics aligns current and future medications with each persons unique genetic profile. We know pharmacogenetics isn’t the “end all, be all” but it is another tool that can be used to help clinicians know the right drug, at the right dose, for the right person.
According to the NIMH (National Institute of Mental Health), less than 30% of depressed patients responded adequately to their initial antidepressant.
One thing a patient with mental health can’t afford, is “trial and error” prescribing. Pharmacogenetics testing allows healthcare professionals to identify patients who might experience adverse effects from antidepressant or antipsychotic medications and help to improve adherence.
One benefit from pharmacogenetic testing is to identify patients who rapidly metabolize medications, also known as ultra-rapid metabolizers. Test results will guide prescribing letting providers know what kind of dose that individual should be taking.
PGx Medical travels the country educating and implementing pharmacogenetics in the field of aging services. Despite the FDA’s “black box warning” of the potentially fatal side effects of antipsychotics for people suffering from dementia, these powerful drugs are too often used as a means of sedating elderly nursing home residents with dementia, as a substitute for appropriate care
Mental Health Illness has no limits. An estimated 1 in 4 Americans over the age of 18 suffers from a diagnosable mental disorder each year.
Today as we bring awareness to these statistics all over the world, let’s stop and think about the available ways to help, support and treat those affected.
For more information on pharmacogenetics, contact: PGx Medical, firstname.lastname@example.org or 405-509-5112.
Each of us have our own unique genetic profile. So why aren’t our treatment plans tailored to fit us?
Twenty years ago the “one size fits all” approach was pretty standard when it came to prescribing medications. But today with the advances in science, healthcare professionals are able to predict your medication response. This information allows doctors to treat each patient as a unique person and tailor treatment to fit.
Many things influence how our bodies respond to medications. Nutrition, drug interactions, environment and yes, genetics. Knowing our genetics can help create an effective treatment plan customized for each individual.
It has been estimated that genetics can account for 20% to 95% of variability in drug disposition and effects as much as 40-60% of adverse drug reactions.
Pharmacogenetic testing can assist in determining if a particular medication will be effective for you, or potentially harmful.
It can improve your quality of life by helping your provider determine the right drug, at the right dose, for your genetic profile. This helps lower costs on unnecessary medications and reduce the risk of possible side effects. This is important for all patients, but particularly in the long term care setting where elderly adults on average take 8 to 10 medications per day.
Now, more than 130 of the most commonly-prescribed drugs include pharmacogenetic guidance, with many including black box warnings.
PGx Medical focuses on educating and implementing pharmacogenetics in the field of aging services. For more information on pharmacogenetics, contact PGx Medical, email@example.com or 405-509-5112.