Randomized, Blinded, Controlled Trial to EValuate the EcOnomic and ClinicaL Outcomes of Utilizing Genetic Testing to Improve Therapeutic Decision-Making COmpared to Empiric Prescribing as the StaNdard of Care
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 100,000
- 试验地点
- 62
- 主要终点
- Number of Participants that Experience of Adverse Events
研究概览
简要总结
The purpose of this study is to evaluate the impact of genetic testing on healthcare decisions and patient outcomes for patients suffering from pain, cardiovascular problems, Arthritis, Type II Diabetes, and/or Mental Health disorders. Results of genetic testing will also be compared with the clinical outcome measures collected to discover novel genetic factors that may influence patient care.
详细描述
The molecular basis of many pharmacogenetic polymorphisms has now been elucidated, with genetic variations resulting in alteration of expression or function of receptors, enzymes, and transporters relevant to the safety and efficacy of a medical treatment. Genetics has been shown to be a significant factor in the variability of responses of medication choices and doses. With the rapid development of cost-effective high throughput molecular genotyping methods, pharmacogenetics has become increasingly important because of its potential to identify patients with increased risk of adverse drug reactions or decreased likelihood of response at standard dosage of drug. By identifying the genetic risks and the most effective therapy for an individual patient, clinicians may improve the efficacy of treatment and decrease the risk of adverse drug events. The addition of pharmacogenetic testing to routine clinical practice may also be extremely helpful because of the cost reduction associated with the identification of patients that will not respond to expensive drugs or with the identification of patients likely to suffer from severe adverse events. There are also tremendous efforts in the pharmaceutical industry to lower the cost for drug development; pharmacogenetics may fulfill the need to provide the right drug to the right patient and to increase the likelihood of success of large phase II and phase III clinical trials.
The purpose of this study is to evaluate how currently available genetic tests are being implemented in various clinics around the United States, and whether this information results in benefits to patient care. Patients presenting to clinics with pain, cardiovascular conditions, Arthritis, Type II Diabetes, and/or Mental Health disorders that are receiving Proove Bioscience's genetic testing will complete validated questionnaires to measure specific outcomes related to their treatment at each clinical visit, including medication efficacy, reduction in adverse drug events, and healthcare utilization. Physicians will document any changes made to treatment regimens, including adjustments to medications or non-pharmacological treatments, and any improvements in the outcome measures. Statistical analysis will be performed to calculate relationships between genotypic and phenotypic data points collected in this study.
The results of this study will provide a measurable understanding of the medical and economic value of implementing genetic testing into clinical care. Furthermore, data points collected will be used to examine novel correlations and associations between single nucleotide polymorphisms and longitudinal clinical outcome measures.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Provide signed and dated informed consent form
- •Willing to comply with all study procedures and be available for the duration of the study
- •Male or Female, at least 18 years of age
- •Currently taking or a candidate for medication
- •Documented or recent complaint within 90 days with initial date of onset
排除标准
- •Severe hepatic or renal disease (where current pharmaceutical dosing is affected and/or requires adjustment of standard dosing prior to PGx testing)
- •Significant diminished mental capacity that is unable to understand the protocol, surveys and questionnaires; unable to read/write English or Spanish.
- •Recent febrile illness that precludes or delays participation by more than 1 month
- •Pregnancy or lactation
- •Participation in a clinical study that may interfere with participation in this study
- •Anything that would place the individual at increased risk or preclude the individual's full compliance with or completion of the study.
结局指标
主要结局
Number of Participants that Experience of Adverse Events
时间窗: Up to 2 years
Severity of Adverse Events Experienced by Participants
时间窗: Up to 2 years
Frequency of participant urine drug screens
时间窗: Up to 2 years
Glucose levels for patients being treated for T2DM
时间窗: 60 days
Function/Disability assessment on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
时间窗: 60 days
Type of Adverse Events Experienced by Participants
时间窗: Up to 2 years
Risk of stroke using the CHA2DS2-VASc Score
时间窗: 60 days
BMI for patients being treated for T2DM
时间窗: 60 days
Pain Scores on the Pain Numeric Rating Scale (NRS)
时间窗: 60 days
Presence and Severity of Generalized Anxiety Disorder on the GAD-2
时间窗: 60 days
Presence and Severity of Depression on the PHQ-2
时间窗: 60 days
Medication dosage prescribed to the participants
时间窗: Up to 2 years
Self-rated response levels to prescribed medications
时间窗: 60 days
Subjects are ask to rate the ability of their medication, on a scale of 0 to 5, to treat their condition and/or relieve their symptoms.
Presence of atrial fibrillation symptoms and their impact on quality of life using the Severity of Atrial Fibrillation (SAF) scale
时间窗: 60 days
Severity of Rheumatoid Arthritis using the Routine Assessment of Patient Index Data (RAPID-3) score
时间窗: 60 days
Type of medication or alternative therapy prescribed for participants, as listed on the Medication Efficacy Differentiation (MED) Scale or on the investigator's evaluation form
时间窗: Up to 2 years
Risk of cardiovascular incidents using the AHA Heart Disease Risk Assessment
时间窗: 60 days
次要结局
- Co-occurring disorders collected by ICD-9/10 codes(60 days)
- Urine drug screen results(60 days)
- Assessment of previous treatments(60 days)
