Joseph Stanton, Marcus Badgeley , Nicole Sweeney , Hailey Lefkofsky , Kyle Lapidus , Joel Dudley
Background – Patients with neuropsychiatric illness have inconsistent responses to medications. Pharmacogenomic testing (PGx) helps identify patients who may better respond to certain medications or carry a greater risk of adverse events. Mobile health apps, like TempusPRO, administer measurement-based care (MBC) to track symptom severity longitudinally and in real-time. Here, we combine PGx and MBC tools into a single platform to further improve patient care.
Methods – We normalized symptom severity scores recorded through TempusPRO to be between 0-1 and compared severity before and after PGx across all assessments (N=355 patients) and on individual assessments completed by ≥20 patients with >2 questions (N=302 patients). User experience was also measured by analyzing patient engagement and retention with TempusPRO (N=635 patients).
Results – Symptom severity decreased following PGx combined with TempusPRO monitoring (-8%, matched-pair t-test P=4e-16). Symptom severities decreased on all 6 individual questionnaires tested. Overall, average user engagement was 5.3 assessments over a 47-day retention period. Patients who received PGx were found to have higher engagement and retention versus patients without PGx (6 vs 4 assessments, 55 vs 26 days, wilcoxon ranked sum test P=7.8e-08
P=3.8e-06). Higher symptom severity was associated with shorter retention, while frequent engagement was associated with improved symptoms.
Conclusion – This analysis utilized digital, out-of-office MBC to quantify symptom trajectories from real-world data following PGx. Our preliminary findings suggest further investigation is warranted for the use of PGx and mobile-app based MBC together, to better inform treatment decisions in clinical settings.
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