PHARMACOGENOMICS AND PRESCRIBING RATES IN NORTHERN IRELAND

Background: Pharmacogenomic-considerate practice represents the next phase of quality healthcare provision.<br/>However, identification of drug-gene interactions that exist among currently prescribed medicines is the first critical step<br/>towards fully understanding prescribing behaviour and ultimate integration of pharmacogenomic-considerate practice into<br/>Northern Ireland.<br/>Aim: The aim of this research is to identify the most commonly prescribed medicines that are deemed to be<br/>pharmacogenomically relevant with actionable drug-gene interactions, and to determine the prescribing rates of these<br/>medicines in Northern Ireland across a 24 month period between January 2021 to December 2022.<br/>Method: Medicines with actionable drug-gene interactions were identified by interrogation of pharmacogenomic<br/>databases including Pharmacogenomics Knowledge Base and the Clinical Pharmacogenetics Implementation<br/>Consortium. Following compilation of the actionable medicines list, quantitative retrospective analysis of Northern Ireland<br/>prescribing data from January 2021 to December 2022 was undertaken. This enabled prescribing rates of medicines in<br/>Northern Ireland with actionable drug-gene interactions to be determined. This data was analysed using Microsoft® Excel®<br/>(Version 2309) and statistical analysis conducted using IBM SPSS® Statistics (Version 29.0.1.0).<br/>Results: Of the 38,847,653 medicinal items prescribed in Northern Ireland from January 2021 to December 2021,<br/>20.71% (n = 8,046,666) were medicines that are known to have actionable drug-gene interactions, with 1,170 different<br/>medicines prescribed in Northern Ireland during this period. Interrogation of pharmacogenomic databases identified 108<br/>medicines classified as having actionable drug-gene interactions. An average of 75.46% (n = 82) were medicines<br/>prescribed in Northern Ireland from January 2021 to December 2022. Of all medicinal items prescribed in Northern<br/>Ireland during this two-year period, 20.53% (n = 8,096,189) were medicines with actionable pharmacogenomic status.<br/>Analysis showed that the largest category of medicines included Central Nervous System medicine (43.21%; n = 35). The<br/>remaining 56.79% of actionable pharmacogenomic medicines prescribed in this period are distributed among 11 other<br/>therapeutic areas including Obstetrics &amp; Gynaecology, Cardiovascular disease and immunosuppression, and<br/>Musculoskeletal disorders and joint disease.<br/>Conclusion: This study highlights that medicines with actionable drug-gene interactions are being prescribed in Northern<br/>Ireland without consideration of interpatient genetic variation. One-fifth of all medicinal items prescribed in Northern<br/>Ireland had actionable drug-gene interactions, validating the necessity for pharmacogenomic services in Northern Ireland.<br/>This work supports the need for widespread pharmacogenomic analysis to become a staple of prescribing<br/>considerations, given such vast prescirbing practice is already in place.<br/>References/Acknowledgments: Bowel Cancer UK. (2021) Bowel cancer patients in Northern Ireland join England and<br/>Wales in receiving DPYD test to screen for serious reactions to chemotherapy. London: Bowel Cancer UK. Available at:<br/>https://www.bowelcanceruk.org.uk/news-and-blogs/research-blog/bowel-cancer-patients-in-england-to-receive-test-to-screen-for-serious-reactions-to-chemotherapy/#:~:text=Testing%20people%20with%20bowel%20cancer,chose%20a%20different%