UCHealth Expands Preemptive PGx for Clopidogrel Across Hospital System, to Other Drugs
Mar 1, 2024UCHealth Expands Preemptive PGx for Clopidogrel Across Hospital System, to Other Drugs
Mar 01, 2024 | Jessica Kim Cohen
NEW YORK – After launching at a single site five years ago, UCHealth in Colorado's clinical decision support (CDS) tool for prescribing a commonly used antiplatelet medication is live across the entire hospital system.
The team behind the CDS system developed and implemented it gradually, expanding it to new indications, sites, and are now using it as a foundation for PGx alerts for additional drug-gene pairs.
The CDS tool started by specifically warning physicians prescribing Bristol Myers Squibb/Sanofi-Aventis' P2Y12 inhibitor Plavix (clopidogrel) when a patient has a documented CYP2C19 gene variant in their medical record that suggests they would metabolize the drug poorly. Plavix is widely used as therapy after heart attack, stroke, and other heart problems, but for patients with certain genetic variants, the medication is less likely to be effective.
Since patients with these pharmacogenetic variants are left at risk for future adverse cardiac events, proactively identifying them and prescribing alternatives can lead to "high-impact outcomes," said David Kao, a cardiologist at UCHealth and medical director of the Colorado Center for Personalized Medicine at the University of Colorado Anschutz Medical Campus.
The CDS tool works by automatically sending an alert within UCHealth's Epic Systems electronic health record (EHR) system when a physician orders Plavix for patients deemed CYP2C19 intermediate or poor metabolizers based on information available in their medical chart. The alert is an interruptive warning — or a "pop-up" — and includes a brief description of the drug-gene interaction and risks, recommendation for alternative therapies, and external link to additional educational information.