{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:42:27Z","timestamp":1791999747187,"version":"4.4.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"16","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>We describe the implementation and ongoing maintenance of CYP2C19 and CYP2D6 focused pharmacogenetic (PGx) testing to guide antidepressant and antianxiety medication prescriptions in a large rural, nonprofit health system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>Depression and anxiety are common psychiatric conditions. Sanford Health implemented PGx testing for metabolism of cytochrome P450 (CYP) isozymes 2C19 and 2D6 in 2014 to inform prescribing for multiple medications, including antidepressant and antianxiety therapies. As guidelines, genotype to phenotype translation, panel offerings, and other resources are updated, we adapt our approach. We make educational and informational materials available to providers and patients. Pharmacogenomic clinical pharmacists review PGx results with discrete values and provide guidance documentation in the electronic medical record. A robust clinical decision support system is in place to provide interruptive alerts, noninterruptive alerts, and genomic indicators. A referral-based interdisciplinary clinic is also available to provide in-depth education to patients regarding PGx results and implications. Additionally, partnering with our health plan has expanded access to PGx testing for patients with anxiety or depression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The implementation and maintenance of Sanford Health\u2019s PGx program to guide antidepressant and antianxiety medication use continues to evolve and requires a multipronged approach relying on both human and informatics-based resources.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxae083","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T16:51:10Z","timestamp":1711644670000},"page":"723-732","source":"Crossref","is-referenced-by-count":10,"title":["Implementation of <i>CYP2C19<\/i> and <i>CYP2D6<\/i> genotyping to guide antidepressant use in a large rural health system"],"prefix":"10.1093","volume":"81","author":[{"given":"Natasha J","family":"Petry","sequence":"first","affiliation":[{"name":"Sanford Imagenetics, Sanford Health, Sioux Falls, SD, and Department of Pharmacy Practice, North Dakota State University , Fargo, ND , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Van Heukelom","sequence":"additional","affiliation":[{"name":"Sanford Imagenetics, Sanford Health, Sioux Falls, SD, and Department of Internal Medicine, University of South Dakota School of Medicine , Vermillion, SD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April J","family":"Schultz","sequence":"additional","affiliation":[{"name":"Sanford Imagenetics, Sanford Health, Sioux Falls, SD, and Department of Internal Medicine, University of South Dakota School of Medicine , Vermillion, SD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Jacobsen","sequence":"additional","affiliation":[{"name":"Sanford Imagenetics, Sanford Health , Sioux Falls, SD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan F","family":"Baye","sequence":"additional","affiliation":[{"name":"Sanford Imagenetics, Sanford Health, Sioux Falls, SD, and South Dakota State University College of Pharmacy and Allied Health Professions , Brookings, SD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Mills","sequence":"additional","affiliation":[{"name":"Sanford Imagenetics, Sanford Health , Sioux Falls, SD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie M","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Sanford Medical Genetics Laboratory, Sanford Health, Sioux Falls, SD, and Department of Internal Medicine, University of South Dakota School of Medicine , Vermillion, SD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Massmann","sequence":"additional","affiliation":[{"name":"Sanford Imagenetics, Sanford Health, Sioux Falls, SD, and Department of Internal Medicine, University of South Dakota School of Medicine , Vermillion, SD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,8,12]]},"reference":[{"key":"2024081218013144000_CIT0001","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.jad.2020.07.102","article-title":"The magnitude and heterogeneity of antidepressant response in depression: a meta-analysis of over 45,000 patients","volume":"276","author":"Guo","year":"2020","journal-title":"J Affect Disord"},{"issue":"11","key":"2024081218013144000_CIT0002","doi-asserted-by":"crossref","first-page":"e0241497","DOI":"10.1371\/journal.pone.0241497","article-title":"On the treatment effect heterogeneity of antidepressants in major depression: a Bayesian meta-analysis and simulation study","volume":"15","author":"Volkmann","year":"2020","journal-title":"PLoS One"},{"issue":"8","key":"2024081218013144000_CIT0003","doi-asserted-by":"crossref","first-page":"e0237950","DOI":"10.1371\/journal.pone.0237950","article-title":"Individual response to antidepressants for depression in adults-a meta-analysis and simulation study","volume":"15","author":"Munkholm","year":"2020","journal-title":"PLoS One"},{"issue":"1","key":"2024081218013144000_CIT0004","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1038\/s41398-022-02221-4","article-title":"Polygenic heterogeneity in antidepressant treatment and placebo response","volume":"12","author":"N\u00f8hr","year":"2022","journal-title":"Transl Psychiatry"},{"issue":"2","key":"2024081218013144000_CIT0005","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.bpsgos.2021.07.008","article-title":"GSRD Consortium; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium; McIntosh AM, Lewis CM. 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