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Implementing Genomics in Practice (IGNITE) Proof of Concept Study: Genotyping in Family Medicine Clinics

ProHealth Family Physicians
St. Cloud, FL


Charles Powers, MD
Chris Baur, MD
Ralph Wurster, DO
Laura Brooks, ARNP
Sarah LeMaster, ARNP

ProHealth Family Physicians is a private, physician-owned and operated family practice serving the St. Cloud, FL area. Providers see a large, very diverse patient base ranging in ages from newborns to seniors. They have been serving patients since 1988. This practice joined the FSU Network for Clinical Research and Training in 2011, with the implementation of two pilot research studies on health risk assessments in adolescents and concussion screening in youth athletes. Most recently, they have elected to serve as an implementation site for a proof-of-concept study that implements CYP2D6 pharmacogenetic testing for the management of pain medications in patients with chronic pain.

A person’s CYP2D6 genotype has important relevance for response to codeine and tramadol and possibly other opioid pain medications that depend on the CYP2D6 protein for activation. Consequences of having a CYP2D6 genetic variant could include life-threatening central nervous system depression and death or, conversely, receiving no pain relief from codeine-containing medications. This genomics study examines whether: 1) CYP2D6 genotyping will lead to better pain management and control; 2) having CYP2D6 genotype results is useful from the physician’s perspective to inform prescribing decisions for pain medication; and 3) genotype results beyond CYP2D6 would be informative for guiding use of other medications prescribed for patients in this setting. Patients are being recruited from multiple family medicine outpatient practices in Florida. Implementation sites, like ProHealth, enroll patients who consent to CYP2D6 genotyping and physicians utilize results in determining pain management. Control sites will provide usual medical care, but physicians will not receive their genotype results for their enrolled patients until completion of the study. Additionally, novel continuing education methods will be employed at sites, incorporating personal genotype evaluation for clinical practice faculty and staff to support our research on educating health care professionals about clinical applications of genomic medicine. This study will continue through April 2016.