# Implementation of Point-of-Care Pharmacogenomic Decision Support in Perioperative Care - Resubmission 01

> **NIH NIH R01** · UNIVERSITY OF CHICAGO · 2022 · $809,925

## Abstract

PROJECT SUMMARY/ABSTRACT
 Adverse drug reactions are a leading cause of death, and thousands of additional patients are prescribed
medications which provide no benefit. Pharmacogenomics has allowed the discovery of genetic variants
impacting response or toxicity for hundreds of drugs, but such information has infrequently been clinically
utilized. Implementation has been hampered by poor physician knowledge, limited avenues for testing, delays
in receipt of results, and informatics barriers to genomic implementation. There is also skepticism regarding the
clinical utility of pharmacogenomics, underpinning the need for randomized examination of clinical efficacy.
 This was the genesis for our interest in proposing this project, which aims to understand whether a novel
decision-support tool delivering patient-specific pharmacogenomic information can demonstrate that
genetically-informed prescribing reduces inappropriate medication use in the perioperative and critical care
settings. We previously developed and studied the tool, called the Genomic Prescribing System (GPS), among
outpatient physician-patient pairs at our institution over the past five (5) years. GPS incorporates preemptively-
obtained patient-specific pharmacogenomic results and translates these into clinical decision support
summaries. The significance of this model is that it addresses several of the primary barriers to genomic
implementation/dissemination–the need for instantaneous access to results at the point-of-care, translation of
genomic information into decision-making logic, and provider education/decision support about genomics.
 We are interested to know whether our conceptual framework for adoption and use of pharmacogenomic
information has unique mediators or unanticipated barriers in the perioperative setting, where anesthesiologists
and critical care providers make many high-stakes prescribing decisions very rapidly. Additionally, in the
perioperative setting the idea of pre-identifying patients who have genomic predisposition to increased
medication risk has the potential for added clinical value that is greater than that for screening in other clinical
populations, because for many perisurgical patients, it will be the first time having an operation (and thus the
first time being exposed to various associated perioperative drugs).
 Our hypothesis is that a medical implementation model for personalized care that makes relevant
pharmacogenomic information instantaneously accessible at the time of prescribing will reduce the
use of inappropriate and high risk medications in patients for whom pharmacogenomic results are
known. This hypothesis is based on the premise that the efficacious clinical translation of genomic discovery
will be mediated by both systems/technology changes and changes in clinician behaviors. Impact on public
health will result not only from the technology we employ but from our understanding of decision-making
processes involved in promoting and ...

## Key facts

- **NIH application ID:** 10424435
- **Project number:** 5R01HG009938-05
- **Recipient organization:** UNIVERSITY OF CHICAGO
- **Principal Investigator:** Peter Hugh O'Donnell
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $809,925
- **Award type:** 5
- **Project period:** 2018-08-27 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10424435

## Citation

> US National Institutes of Health, RePORTER application 10424435, Implementation of Point-of-Care Pharmacogenomic Decision Support in Perioperative Care - Resubmission 01 (5R01HG009938-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10424435. Licensed CC0.

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