Implementation of Standardized Clinical Processes for TPMT Testing in a Diverse Multidisciplinary Population: Challenges and Lessons Learned

Authors

Kristin W. Weitzel, University of Florida
D. M. Smith, University of Florida
Amanda R. Elsey, University of Florida
Benjamin Q. Duong, University of Florida
Benjamin Burkley, University of Florida
Michael Clare-Salzler, University of Florida
Yan Gong, University of Florida
Tara A. Higgins, University of Florida
Benjamin Kong, Oregon Health and Science University
Teresa T. Vo, University of South Florida

Document Type

Article

Publication Date

3-2018

Digital Object Identifier (DOI)

https://doi.org/10.1111/cts.12533

Abstract

Although thiopurine S‐methyltransferase (TPMT) genotyping to guide thiopurine dosing is common in the pediatric cancer population, limited data exist on TPMT testing implementation in diverse, multidisciplinary settings. We established TPMT testing (genotype and enzyme) with clinical decision support, provider/patient education, and pharmacist consultations in a tertiary medical center and collected data over 3 years. During this time, 834 patients underwent 873 TPMT tests (147 (17%) genotype, 726 (83%) enzyme). TPMT tests were most commonly ordered for gastroenterology, rheumatology, dermatology, and hematology/oncology patients (661 of 834 patients (79.2%); 580 outpatient vs. 293 inpatient; P < 0.0001). Thirty‐nine patients had both genotype and enzyme tests (n = 2 discordant results). We observed significant differences between TPMT test use and characteristics in a diverse, multispecialty environment vs. a pediatric cancer setting, which led to unique implementation needs. As pharmacogenetic implementations expand, disseminating lessons learned in diverse, real‐world environments will be important to support routine adoption.

Comments

Complete list of authors: Taimour Langaee, Caitrin W. McDonough, Benjamin J. Staley, Dyson T. Wake, Larisa H. Cavallari, Julie A. Johnson

Rights Information

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Was this content written or created while at USF?

Yes

Citation / Publisher Attribution

Clinical and Translational Science, v. 11, issue 2, p. 175-181

Scholar Commons Citation

Weitzel, Kristin W.; Smith, D. M.; Elsey, Amanda R.; Duong, Benjamin Q.; Burkley, Benjamin; Clare-Salzler, Michael; Gong, Yan; Higgins, Tara A.; Kong, Benjamin; and Vo, Teresa T., "Implementation of Standardized Clinical Processes for TPMT Testing in a Diverse Multidisciplinary Population: Challenges and Lessons Learned" (2018). Pharmacy Faculty Publications. 64.
https://digitalcommons.usf.edu/pharm_facpub/64