{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:54:42Z","timestamp":1785779682920,"version":"3.56.0"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013238","name":"Faculty of Medicine Siriraj Hospital, Mahidol University.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100013238","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    Pharmacogenomic (PGx) data in Thailand remain limited, and genetics-only surveys rarely quantify \u201crealized actionability\u201d\u2014the overlap between actionable PGx phenotypes and real-world medication exposure. We profiled 4,662 Thai adults using SNP-array data and a pre-specified PGx panel (11 genes; 26 markers) with a hybrid required\/optional calling policy for diplotype\/phenotype assignment. CPIC level A\/B gene\u2013drug relationships were linked to hospital electronic medical record (EMR) prescription\/dispensation data to quantify drug-specific realized actionability. Overall callability across gene-results was 98.62%, exceeding 99% for most genes and lower for\n                    <jats:italic>CYP2C19<\/jats:italic>\n                    (95.99%) and\n                    <jats:italic>NUDT15<\/jats:italic>\n                    (90.28%). Across nine phenotype-coded genes, 95.99% carried \u22651 CPIC-actionable result (median 2; IQR 2\u20133). Actionable prevalence among callable individuals was highest for\n                    <jats:italic>CYP3A5<\/jats:italic>\n                    (58.54%) and\n                    <jats:italic>CYP2C19<\/jats:italic>\n                    (56.67%), followed by\n                    <jats:italic>ABCG2<\/jats:italic>\n                    (45.10%) and\n                    <jats:italic>UGT1A1<\/jats:italic>\n                    (27.37%). EMR linkage identified 1,529 (32.58%) participants exposed to \u22651 study medication; omeprazole (n\u2009=\u2009658) and statins were most common (atorvastatin n\u2009=\u2009606; simvastatin n\u2009=\u2009603). Among users, actionable phenotypes were frequent for\n                    <jats:italic>CYP2C19<\/jats:italic>\n                    \u2013omeprazole (55.02%) and\n                    <jats:italic>SLCO1B1<\/jats:italic>\n                    \u2013statins (21.95\u201323.05%). In conclusion, an Asian-optimized SNP array supports scalable PGx phenotyping in Thai adults. EMR linkage quantifies realized actionability and highlights high-yield targets (\n                    <jats:italic>CYP2C19<\/jats:italic>\n                    \u2013proton pump inhibitors;\n                    <jats:italic>SLCO1B1<\/jats:italic>\n                    \u2013statins) for pre-emptive implementation.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0355201","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:22:15Z","timestamp":1785777735000},"page":"e0355201","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacogenomic landscape in Thailand: Array-based profiling and EMR-linked medication exposure"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0646-6245","authenticated-orcid":true,"given":"Phongthana","family":"Pasookhush","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophida","family":"Suta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sureeporn","family":"Pumeiam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pichanun","family":"Mongkolsucharitkul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonggochpass","family":"Pinsawas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suphawan","family":"Ophakas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3816-6463","authenticated-orcid":true,"given":"Korapat","family":"Mayurasakorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"pone.0355201.ref001","article-title":"Pharmacogenetics\/genomics and personalized medicine","author":"W Sad\u00e9e","year":"2005","journal-title":"Hum Mol Genet"},{"key":"pone.0355201.ref002","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1146\/annurev.med.56.082103.104724","article-title":"Pharmacogenomics and individualized drug therapy","volume":"57","author":"M Eichelbaum","year":"2006","journal-title":"Annu Rev Med"},{"issue":"7","key":"pone.0355201.ref003","doi-asserted-by":"crossref","first-page":"940","DOI":"10.3390\/ph17070940","article-title":"Pharmacogenomics: A Genetic Approach to Drug Development and Therapy","volume":"17","author":"R Qahwaji","year":"2024","journal-title":"Pharmaceuticals (Basel)"},{"issue":"12","key":"pone.0355201.ref004","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1056\/NEJMra1010600","article-title":"Genomics and drug response","volume":"364","author":"L Wang","year":"2011","journal-title":"N Engl J Med"},{"issue":"4","key":"pone.0355201.ref005","first-page":"191","article-title":"Pharmacogenomics: the right drug to the right person","volume":"1","author":"A T P","year":"2009","journal-title":"J Clin Med Res"},{"issue":"3","key":"pone.0355201.ref006","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1038\/clpt.2010.279","article-title":"CPIC: Clinical Pharmacogenetics Implementation Consortium of the Pharmacogenomics Research Network","volume":"89","author":"MV Relling","year":"2011","journal-title":"Clin Pharmacol Ther"},{"issue":"1","key":"pone.0355201.ref007","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/cpt.1651","article-title":"The clinical pharmacogenetics implementation consortium: 10 years later","volume":"107","author":"MV Relling","year":"2020","journal-title":"Clin Pharmacol Ther"},{"issue":"3","key":"pone.0355201.ref008","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1002\/cpt.910","article-title":"The Pharmacogene Variation (PharmVar) Consortium: Incorporation of the Human Cytochrome P450 (CYP) Allele Nomenclature Database","volume":"103","author":"A Gaedigk","year":"2018","journal-title":"Clin Pharmacol Ther"},{"key":"pone.0355201.ref009","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1007\/978-1-62703-435-7_20","article-title":"PharmGKB: the Pharmacogenomics Knowledge Base","volume":"1015","author":"CF Thorn","year":"2013","journal-title":"Methods Mol Biol"},{"issue":"6","key":"pone.0355201.ref010","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1002\/cpt.2122","article-title":"Pharmacogenetics at Scale: An Analysis of the UK Biobank","volume":"109","author":"G McInnes","year":"2021","journal-title":"Clin Pharmacol Ther"},{"issue":"1","key":"pone.0355201.ref011","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1002\/cpt.1664","article-title":"Global Pharmacogenomics Within Precision Medicine: Challenges and Opportunities","volume":"107","author":"MJ Chenoweth","year":"2020","journal-title":"Clin Pharmacol Ther"},{"issue":"1","key":"pone.0355201.ref012","doi-asserted-by":"crossref","first-page":"30683","DOI":"10.1038\/s41598-024-79018-6","article-title":"Pharmacogenomic landscape of the Thai population from genome sequencing of 949 individuals","volume":"14","author":"J Piriyapongsa","year":"2024","journal-title":"Sci Rep"},{"issue":"6","key":"pone.0355201.ref013","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0303085","article-title":"Metabolic and genetic risk factors associated with pre-diabetes and type 2 diabetes in Thai healthcare employees: A long-term study from the Siriraj Health (SIH) cohort study","volume":"19","author":"P Mongkolsucharitkul","year":"2024","journal-title":"PLoS One"},{"issue":"5","key":"pone.0355201.ref014","first-page":"1331","article-title":"Genetic and polygenic contributions to familial hypercholesterolemia in Thailand: Implications for diagnosis and lipid management","volume":"19","author":"P Pasookhush","year":"2025","journal-title":"J Clin Lipidol"},{"issue":"1","key":"pone.0355201.ref015","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1038\/s41525-025-00532-1","article-title":"Transferability of polygenic risk scores for metabolic and cardiovascular traits in an underrepresented population","volume":"10","author":"P Pasookhush","year":"2025","journal-title":"NPJ Genom Med"},{"issue":"3","key":"pone.0355201.ref016","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1086\/519795","article-title":"PLINK: a tool set for whole-genome association and population-based linkage analyses","volume":"81","author":"S Purcell","year":"2007","journal-title":"Am J Hum Genet"},{"issue":"22","key":"pone.0355201.ref017","doi-asserted-by":"crossref","first-page":"2867","DOI":"10.1093\/bioinformatics\/btq559","article-title":"Robust relationship inference in genome-wide association studies","volume":"26","author":"A Manichaikul","year":"2010","journal-title":"Bioinformatics"},{"issue":"2","key":"pone.0355201.ref018","doi-asserted-by":"crossref","DOI":"10.1093\/gigascience\/giab008","article-title":"Twelve years of SAMtools and BCFtools","volume":"10","author":"P Danecek","year":"2021","journal-title":"Gigascience"},{"issue":"5","key":"pone.0355201.ref019","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1002\/cpt.2526","article-title":"Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2C19 Genotype and Clopidogrel Therapy: 2022 Update","volume":"112","author":"CR Lee","year":"2022","journal-title":"Clin Pharmacol Ther"},{"issue":"5","key":"pone.0355201.ref020","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1002\/cpt.2557","article-title":"The Clinical Pharmacogenetics Implementation Consortium Guideline for SLCO1B1, ABCG2, and CYP2C9 genotypes and Statin-Associated Musculoskeletal Symptoms","volume":"111","author":"RM Cooper-DeHoff","year":"2022","journal-title":"Clin Pharmacol Ther"},{"issue":"2","key":"pone.0355201.ref021","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1002\/cpt.1830","article-title":"Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2C9 and Nonsteroidal Anti-Inflammatory Drugs","volume":"108","author":"KN Theken","year":"2020","journal-title":"Clin Pharmacol Ther"},{"issue":"3","key":"pone.0355201.ref022","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1002\/cpt.668","article-title":"Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Pharmacogenetics-Guided Warfarin Dosing: 2017 Update","volume":"102","author":"JA Johnson","year":"2017","journal-title":"Clin Pharmacol Ther"},{"issue":"1","key":"pone.0355201.ref023","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1002\/cpt.113","article-title":"Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for CYP3A5 Genotype and Tacrolimus Dosing","volume":"98","author":"KA Birdwell","year":"2015","journal-title":"Clin Pharmacol Ther"},{"issue":"5","key":"pone.0355201.ref024","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1002\/cpt.1304","article-title":"Clinical Pharmacogenetics Implementation Consortium Guideline for Thiopurine Dosing Based on TPMT and NUDT15 Genotypes: 2018 Update","volume":"105","author":"MV Relling","year":"2019","journal-title":"Clin Pharmacol Ther"},{"issue":"4","key":"pone.0355201.ref025","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1002\/cpt.269","article-title":"Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for UGT1A1 and Atazanavir Prescribing","volume":"99","author":"RS Gammal","year":"2016","journal-title":"Clin Pharmacol Ther"},{"issue":"4","key":"pone.0355201.ref026","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1002\/cpt.1477","article-title":"Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2B6 and Efavirenz-Containing Antiretroviral Therapy","volume":"106","author":"Z Desta","year":"2019","journal-title":"Clin Pharmacol Ther"},{"issue":"10","key":"pone.0355201.ref027","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.3390\/pharmaceutics14102082","article-title":"Genotyping of UGT1A1*80 as an Alternative to UGT1A1*28 Genotyping in Spain","volume":"14","author":"A Bravo-G\u00f3mez","year":"2022","journal-title":"Pharmaceutics"},{"issue":"2","key":"pone.0355201.ref028","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3390\/microarrays5020012","article-title":"Advantages of Array-Based Technologies for Pre-Emptive Pharmacogenomics Testing","volume":"5","author":"A Shahandeh","year":"2016","journal-title":"Microarrays (Basel)"},{"issue":"2","key":"pone.0355201.ref029","first-page":"4","article-title":"The Use of SNPs in Pharmacogenomics Studies","volume":"12","author":"ZB Alwi","year":"2005","journal-title":"Malays J Med Sci"},{"key":"pone.0355201.ref030","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1146\/annurev-pharmtox-010814-124835","article-title":"Preemptive clinical pharmacogenetics implementation: current programs in five US medical centers","volume":"55","author":"HM Dunnenberger","year":"2015","journal-title":"Annu Rev Pharmacol Toxicol"},{"issue":"1","key":"pone.0355201.ref031","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1002\/cpt.1643","article-title":"Pharmvar genefocus: Cyp2d6","volume":"107","author":"C Nofziger","year":"2020","journal-title":"Clin Pharmacol Ther"},{"key":"pone.0355201.ref032","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2147\/TACG.S463965","article-title":"The Diversity of CYP2C19 Polymorphisms in the Thai Population: Implications for Precision Medicine","volume":"17","author":"V Nakhonsri","year":"2024","journal-title":"Appl Clin Genet"},{"issue":"6","key":"pone.0355201.ref033","doi-asserted-by":"crossref","first-page":"297","DOI":"10.2217\/pgs-2023-0071","article-title":"Clinical pharmacogenomics implementation in Thailand: a dream come true","volume":"24","author":"C Sukasem","year":"2023","journal-title":"Pharmacogenomics"},{"key":"pone.0355201.ref034","doi-asserted-by":"crossref","first-page":"100399","DOI":"10.1016\/j.dmpk.2021.100399","article-title":"Pharmacogenomics research and its clinical implementation in Thailand: Lessons learned from the resource-limited settings","volume":"39","author":"C Sukasem","year":"2021","journal-title":"Drug Metab Pharmacokinet"},{"issue":"1","key":"pone.0355201.ref035","doi-asserted-by":"crossref","first-page":"6344","DOI":"10.1038\/s41467-025-61644-x","article-title":"Clinical impact of pharmacogenetic risk variants in a large chinese cohort","volume":"16","author":"C-Y Wei","year":"2025","journal-title":"Nat Commun"},{"issue":"6","key":"pone.0355201.ref036","first-page":"685","article-title":"Patterns of Statin Use in a Real-World Population of Patients at High Cardiovascular Risk","volume":"22","author":"I Lin","year":"2016","journal-title":"J Manag Care Spec Pharm"},{"key":"pone.0355201.ref037","doi-asserted-by":"crossref","first-page":"1179546819855656","DOI":"10.1177\/1179546819855656","article-title":"Prevalence and Predictors of Statin Treatment Among Patients With Chronic Heart Failure at a Tertiary-Care Center in Thailand","volume":"13","author":"P Kosuma","year":"2019","journal-title":"Clin Med Insights Cardiol"},{"issue":"7","key":"pone.0355201.ref038","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1097\/FPC.0000000000000504","article-title":"Real-world pharmacogenetics of statin intolerance: effects of SLCO1B1, ABCG2, and CYP2C9 variants","volume":"33","author":"KI L\u00f6nnberg","year":"2023","journal-title":"Pharmacogenet Genomics"},{"issue":"6","key":"pone.0355201.ref039","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1017\/S1463423618000142","article-title":"Evaluation of community pharmacists\u2019 roles in screening and communication of risks about non-steroidal anti-inflammatory drugs in Thailand","volume":"19","author":"P Phueanpinit","year":"2018","journal-title":"Prim Health Care Res Dev"},{"key":"pone.0355201.ref040","doi-asserted-by":"crossref","first-page":"726643","DOI":"10.3389\/fphar.2021.726643","article-title":"Self-Medication With Over-the-counter Medicines Among the Working Age Population in Metropolitan Areas of Thailand","volume":"12","author":"S Chautrakarn","year":"2021","journal-title":"Front Pharmacol"},{"issue":"4","key":"pone.0355201.ref041","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1111\/jgh.15758","article-title":"Thailand guideline 2020 for medical management of gastroesophageal reflux disease","volume":"37","author":"M Maneerattanaporn","year":"2022","journal-title":"J Gastroenterol Hepatol"},{"issue":"9","key":"pone.0355201.ref042","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1007\/s00228-023-03534-z","article-title":"Proton pump inhibitor use: systematic review of global trends and practices","volume":"79","author":"LGT Shanika","year":"2023","journal-title":"Eur J Clin Pharmacol"}],"container-title":["PLOS 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