Clinical Impact

Falls

Each year millions of people over the age of 65 fall. According to the CDC, 1 in 3 older adults will fall during the year. Falling one time doubles the risk of falling again. Falls do not just happen, but are multifactorial in their cause. One of the leading causes of falls is orthostatic hypotension. Orthostatic hypotension causes people to feel dizzy when they stand up and leads to increased fall risk. Certain medications have been shown to cause dizziness including antidepressants, cardiac, blood pressure, diuretics, and anti-psychotics. It is essential that medications are monitored for right dose, right diagnosis and right outcome. One of the methods for ensuring that an older adult is on the right medication is with pharmacogenetics. Pharmacogenetics offers the following benefits:

  • Aligns medications with personal DNA.
  • Optimizes medication use.
  • Identifies responders and non-responders.
  • Avoids adverse drug events such as falls.
  • Reduces trial and error.
  • Reduces costs.
  • Enhances confidence regarding medication use.
  • Provides for person centered medication regimen.
Pain

Chronic pain is a growing problem among older adults.  Research indicates that 50-75% of elders suffer from chronic pain. Assessment of both acute and chronic pain may be difficult as elders don’t often report pain but believe it is part of the aging process. When left untreated pain impacts the quality of life and can contribute to sleep problems, decreased mobility, falls, depression and anxiety. It is essential that interventions for pain include both pharmacological and non-pharmacological approaches. It is critical that pain medications are monitored for efficacy and potential side effects. One of the methods for ensuring that an older adult is on the right pain medication is with pharmacogenetics. Pharmacogenetics offers the following benefits:

  • Aligns medications with personal DNA.
  • Optimizes medication use.
  • Identifies responders and non-responders.
  • Avoids adverse drug events such as serious side effects.
  • Reduces trial and error.
  • Reduces costs.
  • Enhances confidence regarding medication use.
  • Provides for person centered medication regimen.
Depression

Older adults are at increased risk for depression. They are often misdiagnosed and undertreated. Anti-depressants can contribute to an increased risk of falls as a result of orthostatic hypotension. Genetic factors are believed to play a major role in the variation of treatment response and the incidence of adverse effects to medication (Dialogues in Clinical Neuroscience, 2005). Pharmacogenetics assists in the alignment of medications with personal DNA. Benefits include:

  • Aligns medications with personal DNA.
  • Optimizes medication use.
  • Identifies responders and non-responders.
  • Avoids adverse drug events such as serious side effects.
  • Reduces trial and error.
  • Reduces costs.
  • Enhances confidence regarding medication use.
  • Provides for person centered medication regimen.
Antipsychotic/Dementia

An estimated 25% of nursing home and 13% of assisted living residents in the United States receive at least one antipsychotic medication in a given year. These medications are often used off-label and put the resident at risk for serious side effects. CMS has focused surveys on the reduction of antipsychotics in the nursing home over the past few years and rates have slowly declined. Antipsychotic rates in nursing homes are required to be monitored as part of an overall quality program. The antipsychotic prescribing rate in both assisted living and nursing homes and the relationship between the use of antipsychotics and mortality remain an area of concern for providers, patients and families. It is essential that if used, antipsychotics should be carefully monitored to ensure efficacy and safety of the drug. One of the methods for ensuring that an older adult is on the right drug is pharmacogenetics. Pharmacogenetics offers the following benefits:

  • Aligns medications with personal DNA.
  • Optimizes medication use.
  • Identifies responders and non-responders.
  • Avoids adverse drug events such as serious side effects.
  • Reduces trial and error.
  • Reduces costs.
  • Enhances confidence regarding medication use.
  • Provides for person centered medication regimen.