Perioperative Medication Risk

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The inception of gene: drug related interactions has driven the medication industry into an arena of not only tailoring medication management but an era that can reform healthcare outcomes and deliver a more manageable roadmap to patient care.

The Genomic Perioperative Medication Risk Solution (PPMRS) looks at a number of known genetic pathways related to surgical medication, their appropriateness based on risk and genetics, and mutations that can cause complications during and after surgery. The goal of every test is to,

  1. determine a patient’s risk for adverse drug events to these medications,
  2. risk for malignant hypothermia, and
  3. ability to metabolize opioids to reduce the potential risk for misuse of prescribed opioids so to prevent unnecessary prescribing.

The knowledge contained within our evidence-based system can help anesthesiologists to deliver an appropriate medication plan for each patient to predict and prevent complications before and during. Our solution goes a step further to allow the patient’s practitioners access to the genetic interpretations for all medication the patient may be on, now and in the future, to ensure healthier and less risky outcomes.

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OUR TEST

Genomic Peri-operative Medication Risk Solution utilizes a PGx test by obtaining a simple cheek swab from the patient at least 2 weeks before surgery. The test provides valuable information that cannot be obtained from a patient history and physical examination alone. Genomic’s genetic test evaluates the genes that interact with the drugs most commonly used during surgery. The test results help to assess the medication risk to the patient and inform discussions about the risks of existing therapies and benefits of using alternative options for surgery. Additionally, the test will help to predict post-operative complications that may arise due to existing conditions and medications the patient is on and establish a baseline measurement for continued care.

The type of PGx testing Genomic Genetics preforms allows practitioners to understand if a patient can metabolize opioids. Not being able to metabolize opioids is part of our nations opioid epidemic. Know the opioid status of your patient BEFORE you prescribe and understand if a non-opioid alternative is a better choice.

The life-threatening clinical syndrome of hypermetabolism involving the skeletal muscle known as malignant hyperthermia occurs in 1 in 5,000 to 50,000 instances in which people are given anesthetic gases. Susceptibility to malignant hyperthermia is probably more frequent, because many people with an increased risk of this condition are never exposed to drugs that trigger a reaction.

Genomic’s genetic test looks at 3 genes that can render an individual’s classification of MH as pathogenic and therefore inform the anesthesiologist of the susceptibility so to prescribe anesthetics appropriately on an individual basis.

PROBLEM/CHALLENGES

While doctor-patient communication is a key determinant in adherence to many care plans, the importance of surgeon-patient communication is amplified by the invasiveness, risk, and complexity of surgical procedures. There is not only the procedure itself to consider, but a whole host of preoperative medication considerations, postoperative instructions, and medications to manage. Too often surgical patients suffer from adverse events and they often end up back in the hospital or in poor recovery due to the existing one-size-fits-all medication prescribing habits.

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WHAT OUR SOLUTION PROVIDES

Our approach takes the guesswork out of how the patient will reach to surgical meds, whether they will suffer an MH episode and if the right medication choice is an opioid. Medically necessary procedures are more popular than ever before due to the implementation of new non- or minimally-invasive techniques and tools allowing surgical procedures and patients recovery to be quicker than normal. As a medical professional, you understand the importance of knowledge and practiced skill when it comes to obtaining the most effective results. So, you owe it to yourself and your future patients to hone your surgical care plan.

Genomic Genetics has developed an advanced commercial perioperative risk-assessment tool with the objective of implementing:

  • pre-operative medication optimization,
  • intra-operative risk assessment and management, and
  • post-operative complication prediction and patient handoff.

Genomic Genetics has developed a proprietary panel of peer-reviewed pharmacogenetics markers to accomplish these goals. Building upon a foundation of clinically relevant pharmacogenomic variants, we also include markers that identify the risk of malignant hyperthermia and opioid usefulness and dependency. Additionally, as an increasing number of surgeries are moving through inpatient and outpatient settings, a risk-stratification tool based on the prediction of post-operative complications plays a role in deciding the best treatment setting for individuals.

HOW GENOMIC IS DIFFERENT

Peri-operative Care

  • A single buccal sample can cover all 3 tests: Peri-operative, MH and opioid appropriateness
  • Non-invasive buccal sample is needed for MH test
  • Pharmacy consult available to anesthesiologists
  • Pharmacy consult with patient’s physician for post-operative care management
  • DST for use at any time for better medication selection

Other Tests

  • Multiple samples need to be taken from a patient to result all 3 tests
  • MH is an invasive biopsy of muscle tissue requiring an additional recovery period
  • Results are not accompanied by a pharmacist’s review
  • Results likely are not provided to patient’s physician for post-surgical care
  • No availability of a DST for assessing alternative, more appropriate medications

KEY GOALS

Employers are able to provide their employees and dependants the ultimate healthcare solution by utilizing our medication risk management solution and advanced treatment platform. In addition, we are able to reduce the rising costs of healthcare and pharmacy by deploying a true wellness solution designed for their employee population, employee family members, and covered lives

  • Supports clinicians not only in making new prescribing decisions but also toward deprescribing and rationalizing a person’s overall medication regimen
  • Identifies the fact that many people have genetic variants that negatively impact their response to medications.
  • Performs risk analyses to show that A major impact of getting the medications wrong can be wasted dollars on medications that are not right for that person.
  • Eliminates the traditional methods of trial & error prescribing, which is not the safest, nor the most effective method for treating patients who may not properly metabolize a specific prescribed medication.
  • Stratifies the risks around Taking the wrong medication and how it has more than just a health impact on patients; it is a cost impact as well – wasted dollars on medications that don’t work
  • Pharmacists at every step of the way

WORKFLOW

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SAMPLE REPORT

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