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We evaluated the feasibility of implementing\n                      <jats:italic>CYP2D6<\/jats:italic>\n                      \u2010guided opioid prescribing for patients with cancer and reported pilot outcome data.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Adult patients from two cancer centers were prospectively enrolled into a hybrid implementation\u2010effectiveness clinical trial and randomized to\n                      <jats:italic>CYP2D6<\/jats:italic>\n                      \u2010genotype\u2010guided opioid selection, with clinical recommendations, or usual care. Implementation metrics, including provider response, medication changes consistent with recommendations, and patient\u2010reported pain and symptom scores at baseline and up to 8\u2009weeks, were assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Most (87\/114, 76%) patients approached for the study agreed to participate. Of 85 patients randomized, 71% were prescribed oxycodone at baseline. The median (range) time to receive\n                      <jats:italic>CYP2D6<\/jats:italic>\n                      test results was 10 (3\u201337)\u2009days; 24% of patients had physicians acknowledge genotype results in a clinic note. Among patients with\n                      <jats:italic>CYP2D6<\/jats:italic>\n                      \u2010genotype\u2010guided recommendations to change therapy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911), 18% had a change congruent with recommendations. Among patients who completed baseline and follow\u2010up questionnaires (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200948), there was no difference in change in mean composite pain score (\u22121.01\u2009\u00b1\u20092.1 vs. \u22120.41\u2009\u00b1\u20092.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.19) or symptom severity at last follow\u2010up (3.96\u2009\u00b1\u20092.18 vs. 3.47\u2009\u00b1\u20091.78;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.63) between the usual care arm (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200926) and genotype\u2010guided arm (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study revealed high acceptance of pharmacogenetic testing as part of a clinical trial among patients with cancer pain. However, provider response to genotype\u2010guided recommendations was low, impacting assessment of pain\u2010related outcomes. Addressing barriers to utility of pharmacogenetics results and clinical recommendations will be critical for implementation success.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.2875","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T08:43:03Z","timestamp":1694508183000},"page":"1286-1296","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["<scp>\n                      <i>CYP2D6<\/i>\n                    <\/scp>\n                    \u2010guided opioid therapy for adults with cancer pain: A\u00a0randomized implementation clinical trial"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1460-4000","authenticated-orcid":false,"given":"Scott A.","family":"Mosley","sequence":"first","affiliation":[{"name":"Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine University of Florida  Gainesville Florida USA"},{"name":"Department of Clinical Pharmacy University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3595-9321","authenticated-orcid":false,"given":"Emily","family":"Cicali","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Del\u00a0Cueto","sequence":"additional","affiliation":[{"name":"Department of Individualized Cancer Management H. Lee Moffitt Cancer Center and Research Institute  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane G.","family":"Portman","sequence":"additional","affiliation":[{"name":"Department of Supportive Care Medicine H. Lee Moffitt Cancer Center and Research Institute  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine A.","family":"Donovan","sequence":"additional","affiliation":[{"name":"Department of Supportive Care Medicine H. 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