Date of this Version

7-25-2024

Document Type

DNP Project

Abstract

Psychiatric disorders in children and adolescents have multifactorial etiologies encompassing genetic and environmental factors. The increasing incidence of mental health issues in this population, exacerbated by the COVID-19 pandemic, has highlighted the need for more precise treatment strategies. Pharmacogenomic (PGx) testing, which tailors medication selection based on genetic profiles, offers a promising approach to improving psychiatric care. Despite the potential benefits of PGx testing, its application in child and adolescent psychiatry remains limited due to insufficient high-quality evidence. This study aims to evaluate the clinical outcomes of PGx testing in a pediatric population at an outpatient mental health practice in Miami, Florida. This quality improvement (QI) project involved a retrospective chart review of 10 pediatric patients aged 7-17 who underwent PGx testing. Data were collected on demographics, psychiatric and medical comorbidities, genetic variants, and clinical outcomes measured using the Clinical Global Impressions (CGI) Scale. Descriptive statistics, distribution, correlation, and regression analyses were conducted to assess the relationships between genetic variants, medication trials, side effects, and treatment responses. The sample included predominantly Caucasian/Hispanic adolescents with an average age of 13.6 years. ADHD was the most common primary diagnosis. PGx tests utilized included Genomind, Genesight, Tempus, and Toolbox, with Genomind being the most frequently used. Notably, 50% of patients exhibited marked improvement in medication response, and 40% showed moderate improvement. The analysis indicated a weak positive correlation between the number of medication trials and CGI-I scores, suggesting that more trials were associated with slightly worse treatment responses. Regression analysis revealed that genetic variants and the number of medication trials did not significantly predict treatment response, highlighting the need for larger sample sizes. The findings suggest that PGx testing can enhance treatment efficacy by tailoring medication choices based on individual genetic profiles. PGx testing shows promise in improving the precision of psychopharmacological treatment in children and adolescents, potentially reducing the trial-and- error process of medication adjustments. Integrating PGx testing into clinical practice could enhance treatment outcomes, adherence, and overall quality of life for pediatric patients with psychiatric disorders. Further research is necessary to establish its broader clinical utility and cost-effectiveness.

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