Health care providers were offered access to a genetic test as part of the patient's health benefit to identify the patient's ability to metabolize clopidogrel. Nearly 500 patients completed the test, with approximately one-third of patients identified as being poor drug metabolizers. While the patients who underwent genetic testing were significantly more likely to have their antiplatelet regimen changed as compared to patients who did not undergo testing, only 20.5 percent of patients identified as being poor metabolizers had their antiplatelet therapy intensified or changed to another drug.
"In this study, about half of the providers that were contacted about the availability of a genetic testing benefit did not respond at all, and among those who did decide to use the test, the vast majority of patients identified as poor metabolizers did not have a change in therapy despite FDA warnings suggesting that they should," said Niteesh K. Choudhry, MD, PhD, associate physician, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, associate professor, Harvard Medical School and the study's senior investigator. "While there is significant uncertainty about how clinician's should respond to the results of genetic testing for antiplatelet drugs, this study clearly shows that patients and their doctors need more guidance and education about how best to apply these results to improve patient outcomes."
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