The Clinical Pharmacogenomics Service (CPS) at Boston Children’s Hospital works to make medications safer and more effective by incorporating patient’s genetic information when making decisions about medication choices. We are a unique service; one of only a small handful of centers in the country that apply genetics to determine variations in medication response to improve clinical care.
When choosing a drug, prescribers (physicians, nurse practitioners, physician’s assistants) consider many variables in order to determine the best medication and dose for you. This includes your diagnosis, other medical conditions/personal characteristics, allergies, previous medication history, and many other clinical characteristics. Yet, people who appear to be similar for all these categories may respond quite differently to the same medication. Some people experience side effects that may range from mild to severe; while others may observe no effect at all. By determining an individual’s pharmacogenetic background, we can optimize medication choices that are safer and more likely to work.
The Clinical Pharmacogenomics Service (CPS) is focused on choosing the right drugs for treatment
This is because:
- there is a concern about possible reactions, which may based on family or past experiences
- there is a lack of response to medication
- unexpected side effects.
The nature of medication response can be explained, in part, by genetics. Differences in our genes can directly influence how medications are broken down and how they act. Pharmacogenomics is a branch of personalized medicine that focuses on the application of this genetic information to better inform medication choices based on the individual’s “pharmaco”genes that instruct how they will process a medicine, allowing us to better predict whether a person is likely to respond to the medication and whether they are more or less likely to develop side effects.
Additionally, since DNA is inherited, results from the pharmacogenomics tests may be relevant for related family members as well. If clinically significant results are detected, testing may be considered for these family members.
Why choose Clinical Pharmacogenomics Service (CPS) at Boston Children’s Hospital?
The CPS team oversees the ordering, analysis, interpretation, and counseling associated with pharmacogenomic testing at Boston Children’s Hospital. The available tests include analysis of genes affecting medication breakdown, transport, and response. Results from these tests are analyzed by the CPS team to provide any insight into past medication history and to guide future prescribing decisions to help ensure that medications are chosen and dosed in a manner that is safe and effective as far as possible. When genetic variants of significance are detected, results may suggest that increased monitoring for side effects or dose changes are appropriate for certain medications due to modified medication breakdown. Findings may also suggest the prioritization of specific medications or medication classes based on predicted response. In other instances, total avoidance of particular medications may be recommended due to increased risk of serious adverse drug events. The results are also valuable even when no significant variants are detected, as prescribers can be reassured that therapeutic modification based on genetic factors is not necessary.
Our approach to patient care is interdisciplinary, with specially trained pharmacists and geneticists working in tandem to provide the most current perspectives, recommendations, and guidance pertaining to pharmacogenomics. We collaborate with prescribers from all specialties to incorporate findings into the clinical decision making process where appropriate. Our expectation is that by finding the right medications and doses that work best for you, we can reduce side effects, increase your chances of successful treatment, and help you achieve better health outcomes.