# Clinical Expansion of Precision Medicine in the Emergency Department

> **NIH NIH R01** · UNIVERSITY OF FLORIDA · 2024 · $672,525

## Abstract

PROJECT SUMMARY
 Pharmacogenetic (PGx) testing may be particularly beneficial in patients who visit the emergency
department (ED) because most presenting patients are experiencing significant problems related to their
disease and/or associated medication(s). Moreover, most of the patients visiting the ED will either be admitted
to the hospital or receive follow-up outpatient care in the near future. Our long-term goal is to identify patient
populations where precision medicine can improve clinical outcomes and reduce healthcare costs. The overall
objective of this application is to assess the feasibility, effectiveness, and economic impact of clinically
implementing PGx testing, with appropriate prescribing decision support, in the ED setting. The central
hypothesis is that providing such an intervention will reduce ED return visits and thus healthcare costs. The
rationale for the proposed research is that PGx results, with appropriate prescribing decision support, should
empower prescribers to further individualize their medication prescribing, which should decrease the rate of
medication ineffectiveness and side effects.
 We plan to test the central hypothesis and accomplish the overall objective of this application by pursuing
three specific aims. The first aim is to expand PGx-based decision support resources for clinicians in the
emergency and post-emergency settings. We will accomplish this aim by expanding PGx decision support to
include drug-drug-gene interactions, pharmacist medication reviews, additional gene-drug pairs, and
expanding prescribing recommendations to outside the health system will increase clinical uptake of precision
medicine. The second aim is to determine the feasibility and effectiveness of implementing PGx testing in
high-risk patients who frequently visit the emergency department. We will accomplish this aim by completing a
randomized, pragmatic clinical trial comparing high-risk ED patients receiving PGx testing to those receiving
usual care. We will assess ED return rates, hospitalization rates, as well as key implementation metrics. The
third aim is to quantify the cost-effectiveness and net benefit associated with implementation of PGx testing
given various levels of emergency department return rate reduction. We will accomplish this aim with three
analyses first estimating the cost-effectiveness of this approach and then comparing the cost-benefit using
cost-per-(averted) revisit as the main outcome and comparing intervention to usual care.
 The proposed research is significant because it should help to identify methods to improve care while
reducing costs and address multiple established barriers to PGx implementation. The proposed research is
innovative because it will research an understudied, yet at-risk patient population. Ultimately, we expect to
have important effectiveness, feasibility, and economic data regarding expanding precision medicine efforts in
the ED setting. These results should have a positi...

## Key facts

- **NIH application ID:** 10993741
- **Project number:** 1R01HG013416-01A1
- **Recipient organization:** UNIVERSITY OF FLORIDA
- **Principal Investigator:** Julio David Duarte
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $672,525
- **Award type:** 1
- **Project period:** 2024-09-23 → 2030-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10993741

## Citation

> US National Institutes of Health, RePORTER application 10993741, Clinical Expansion of Precision Medicine in the Emergency Department (1R01HG013416-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10993741. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*