4CPS-212 Cross-sectional study to assess the use and rationality of pharmacogenomics in psychiatric wards

<h3>Background and Importance</h3> Personalised medicine, including Therapeutic Drug Monitoring (TDM) and Pharmacogenomics (PGx), significantly enhances psychiatric care by ensuring treatments are tailored to each patient. Pharmacogenomics is the study of how a patient’s genetics affects the response to drugs. The personalised approach helps in selecting the right drug and dosage, reducing adverse effects and improving therapeutic outcomes. PGx in psychiatric patients should be considered if the drug in question is metabolised by CYP2D6, CYP2C9 or CYP2C19 where considerable genetic variations are recognised. <h3>Aim and Objectives</h3> To investigate the extent of and rational use of PGx in a psychiatric clinical setting. <h3>Material and Methods</h3> In a cross-sectional study, patients from three psychiatric wards in one hospital were included consecutively for 5 weeks. Adult patients with schizophrenia, depression or a bipolar disorder were included and their prescription data on antipsychotics, antidepressants and/or mood stabilisers were extracted from patient records as well as laboratory results. The use of PGx was analysed by clinical pharmacists associated with the wards and deemed as rational if the patient has had more than one shift in psychotherapeutic treatment and the treatment drug was metabolised by CYP2D6, CYP2C9 or CYP2C19 and the corresponding test had been ordered. <h3>Results</h3> From May-April 2024 100 patients were included and assessed. In 21 cases PGx has been used rationally, and in 17 cases there had been no PGx test which was also rational according to the method. However, in 1 case a test had been done irrationally, and in 61 cases it was deemed irrational that no tests had been done. <h3>Conclusion and Relevance</h3> The overall use of PGx in the investigated setting was very limited. In 61% of patients there had been more than one shift in pharmacotherapy regarding drugs dependent on CYP2D6, CYP2C9 or CYP2C19 where PGx test is advised. The results emphasise the need for pharmacological guidance in psychiatric wards which may be provided by clinical pharmacist. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest