Ensuring Equity in Pharmacogenetics for Rural and Underserved Communities

PROJECT SUMMARY/ABSTRACT Pharmacogenetics (PGx) can greatly impact prescribing practices by ensuring a personalized approach to drug treatment, however, access to PGx for rural and underserved communities (i.e. tribal, socioeconomically disadvantaged) is inequitably distributed. The primary objective of this research project is to evaluate and assess the clinical impact and utility of PGx implementation in Montana, with a specific focus on implementation for rural and underserved communities. With a goal to ensure equitable dissemination of innovations like PGx, this project aims to assess the prescribing patterns of PGx medications in rural and underserved settings (Aim 1) and gather insights into the clinical utility and uptake of PGx testing among health care providers (Aim 2). We will also conduct biostatistical and geospatial analysis of the prescribing patterns of PGx medications in rural and underserved areas and identify the optimal therapeutic areas and geographic locations for targeted PGx implementation. We will complete a comprehensive assessment of the clinical utility and uptake of PGx implementation among health care providers in Montana through qualitative surveys. Data will include provider demographics and practice setting location, frequency of PGx consultations, and assessment of prescribing changes based on PGx results (e.g., dose adjustment, medication selection, discontinuation). The results obtained from this project will contribute to advancing PGx implementation strategies in Montana, and will serve as a valuable foundation for future research and implementation efforts in rural and underserved areas across the US. We will oversee the entire research project including survey development and distribution, health data collection, biostatistical and geospatial analysis, and complete interpretation of results. We plan to complete the outlined proposal with the support and supervision of investigators in the L.S. Skaggs Institute for Health Innovation and the Center for Population Health Research at the University of Montana. The postdoctoral fellow will receive training to promote her growth as an independent investigator, completing rigorous training in biostatistical and geospatial analysis, data visualization, and programming, earning certificates in both Bioinformatics and Data Science. The fellow will also attend and submit abstracts to scientific meetings, supervise research students, and provide instruction for pharmacy and graduate students. The data gathered in this proposal will be used by the postdoctoral fellow to secure extramural research funding to establish a career as an independent investigator in the field of PGx, implementation science, and health outcomes research. To attain health equity, it is essential to provide all patients with access to innovative health technologies regardless of geographic location, ancestry, or socioeconomic status. The insights derived from our research will contribute to integrating evidence-based gene-guided prescribing into standard health practices, thereby fostering a paradigm shift towards personalized and equitable treatment approaches.