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Evaluating the prospective utility of pharmacogenetics reporting among Canadian Armed Forces personnel receiving pharmacotherapy: a preliminary assessment towards precision psychiatric care
  1. Maya Roth1,2,
  2. L King3,
  3. K St Cyr2,4,
  4. U Mohsin5,
  5. K Balderson3,
  6. S Rhind6,
  7. A Goldman7 and
  8. D Richardson2,3
  1. 1Operational Stress Injury Clinic—Greater Toronto Site, St. Joseph's Health Care, London, Toronto, Ontario, Canada
  2. 2MacDonald Franklin Operational Stress Injury Research Centre, London, Ontario, Canada
  3. 3Operational Stress Injury Clinic - Parkwood Main Site, SJHC, London, Ontario, Canada
  4. 4University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
  5. 5University of Toronto, Toronto, Ontario, Canada
  6. 6Defence Research and Development Canada, Toronto, Ontario, Canada
  7. 7DNA Labs Canada Inc, Toronto, Ontario, Canada
  1. Correspondence to Dr Maya Roth, Operational Stress Injury Clinic, Greater Toronto Site, St Joseph's Health Care, London, Toronto, M2N 7E9, Canada; Maya.Roth{at}sjhc.london.on.ca

Abstract

Pharmacological interventions for treating posttraumatic stress disorder in Canadian Armed Forces (CAF) members and Veterans often achieve modest results. The field of pharmacogenetics, or the study of how genes influence an individual’s response to different medications, offers insight into how prior knowledge of gene-drug interactions may potentially improve the trial-and-error process of drug selection in pharmacotherapy, thereby improving treatment effects and remission rates. Given the relative recency of pharmacogenetics testing and sparse research in military samples, we used pharmacogenetics testing in a small pilot group (n=23) of CAF members and Veterans who were already engaged in pharmacotherapy for a service-related mental health condition to better understand the associated opportunities and challenges of pharmacogenetics testing in this population. Our preliminary evaluation involved: (1) reporting the prevalence of pharmacogenetics testing ‘bin’ status according to participants’ reports (‘green’, ‘yellow’ or ‘red’; intending to signal ‘go’, ‘caution’ or ‘stop’, regarding the potential for gene-drug interactions); (2) calculating the percentage of currently prescribed psychotropic medications that were assessed and included in the reports; (3) evaluating whether prescribers used pharmacogenetics testing information according to clinical notes and (4) collecting informal feedback from participating psychiatrists. While pharmacogenetics testing appeared to provide valuable information for a number of clients, a major limitation was the number of commonly prescribed medications not included in the reports.

  • mental health
  • psychiatry
  • adult psychiatry

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Footnotes

  • Twitter @A_Goldman

  • Contributors MR conceptualised the project. LK and KStC implemented methodology and ethics submission. All authors contributed to manuscript preparation and revision.

  • Funding Partial funding for this study was provided by MR research fund at the Lawson Health Research Institute in London, Ontario, Canada.

  • Competing interests AG was an employee and shareholder of DNA Labs Canada at the time of this study. AG did not have access to the data or statistical analyses. MR, LK, KStC, UM, KB, SR and DR have no financial ties to DNA Labs Canada Inc.

  • Provenance and peer review Commissioned; externally peer reviewed.