{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T13:31:53Z","timestamp":1777987913178,"version":"3.51.4"},"update-to":[{"DOI":"10.3310\/nihropenres.14182.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000}}],"reference-count":15,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014653","name":"Manchester Biomedical Research Centre","doi-asserted-by":"publisher","award":["NIHR203956"],"award-info":[{"award-number":["NIHR203956"]}],"id":[{"id":"10.13039\/100014653","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["AcademicClinicalLecturer"],"award-info":[{"award-number":["AcademicClinicalLecturer"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006041","name":"Innovate UK","doi-asserted-by":"publisher","award":["10058536"],"award-info":[{"award-number":["10058536"]}],"id":[{"id":"10.13039\/501100006041","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Doctoral Fellowship (DRF) Programme","award":["NIHR301748"],"award-info":[{"award-number":["NIHR301748"]}]},{"name":"NHS England Genomics Programme through the Pharmacogenetics and Medicines Optimisation Network of Excellence","award":["NWGMSA29112024"],"award-info":[{"award-number":["NWGMSA29112024"]}]}],"content-domain":{"domain":["openresearch.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["NIHR Open Res"],"abstract":"<ns7:p>\n                    Background People living with life limiting conditions such as incurable cancer often have problems with pain, vomiting and other symptoms which impact quality of life. Supportive and Palliative Care aims to improve people\u2019s symptoms, particularly towards the very end of life. Many medications exist that can be used to help with these symptoms, but often they do not work, or they cause side effects for the people taking them. \u201cPharmacogenomics\u201d is a way of predicting who is more likely to have a good response to drugs, and who is more likely to get side effects, based on variation in their genes. Methods A prospective observational study, recruiting 50 patients aged over 18, with life limiting conditions. The study aims to understand how the introduction of multi-gene pharmacogenetic test for patients receiving palliative and supportive care might impact routine prescribing practice in an acute NHS hospital setting. It will report on the nature of prescribing patterns over a 90-day period post recruitment, looking for any variation between patients with and without the presence of actionable drug-gene interactions. It will help determine the future feasibility of incorporating pharmacogenomic testing in a palliative care population based on recruitment targets versus actual recruitment achieved. A drug-gene interaction ratio for this cohort will be reported, giving an indication of the scale of the use of medications relevant to pharmacogenomics used in palliative care, and the potential scope of future interventions. The study involves the collection of a single blood sample, and genetic results will not be shared with participants. Discussion This single site study aims to provide preliminary data to inform study design of clinical trials that can definitively address the question of clinical utility in this population, whilst also understanding the acceptability of researching this topic in this specific patient population. Trial registration\n                    <ns7:ext-link xmlns:ns8=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" ns8:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/ns7:ext-link>\n                    ID\n                    <ns7:ext-link xmlns:ns8=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" ns8:href=\"http:\/\/clinicaltrials.gov\/ct2\/results?term=NCT06856122\">NCT06856122<\/ns7:ext-link>\n                    , registered 2025-03-04 URL:\n                    <ns7:ext-link xmlns:ns8=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" ns8:href=\"https:\/\/clinicaltrials.gov\/study\/NCT06856122\">https:\/\/clinicaltrials.gov\/study\/NCT06856122<\/ns7:ext-link>\n                  <\/ns7:p>","DOI":"10.3310\/nihropenres.14182.2","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T05:14:08Z","timestamp":1775798048000},"page":"125","update-policy":"https:\/\/doi.org\/10.3310\/nihropenres.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacogenomics to Improve Supportive Care Symptoms. A Prospective Observational Study Protocol"],"prefix":"10.3310","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9313-3894","authenticated-orcid":false,"given":"Martyn","family":"Patel","sequence":"first","affiliation":[{"name":"Norwich England Norfolk and Norwich University Hospital NHS Foundation Trust"},{"name":"Norwich England University of East Anglia Norwich Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"McDermott","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust Manchester England Manchester Centre for Genomic Medicine"},{"name":"Evolution, Infection and Genomics, School of Biological Sciences Manchester England The University of Manchester"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Newman","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust Manchester England Manchester Centre for Genomic Medicine"},{"name":"Evolution, Infection and Genomics, School of Biological Sciences Manchester England The University of Manchester"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Barry","sequence":"additional","affiliation":[{"name":"Norwich England Norfolk and Norwich University Hospital NHS Foundation Trust"},{"name":"Norwich England University of East Anglia Norwich Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6221","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"ref1","article-title":"National audit of care at the end of life","year":"2024. Accessed 17 Sept 2025"},{"key":"ref2","article-title":"Parliamentary and health service ombudsman annual report 2015.","year":"17 Sept 2025"},{"key":"ref3","article-title":"Marie curie better end of life report.","year":"2024; Accessed Sept 2025"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1528-1537","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."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"521-532","DOI":"10.1016\/S0140-6736(19)31276-0","article-title":"Pharmacogenomics.","volume":"394","author":"D Roden","year":"2019","journal-title":"Lancet."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"888-896","DOI":"10.1002\/cpt.2149","article-title":"Clinical pharmacogenetics implementation consortium guideline for CYP2D6, OPRM1, and COMT genotypes and select opioid therapy.","volume":"110","author":"K Crews","year":"2021","journal-title":"Clin Pharmacol Ther."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2534-2542","DOI":"10.1002\/bcp.70057","article-title":"Implementation of mass pharmacogenetic testing: dihydropyrimidine dehydrogenase testing prior to fluoropyrimidine treatment for patients.","volume":"91","author":"N Shaunak","year":"2025","journal-title":"Br J Clin Pharmacol."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2907-2925","DOI":"10.1111\/bcp.14704","article-title":"Estimating the potential impact of implementing pre-emptive pharmacogenetic testing in primary care across the UK.","volume":"87","author":"E Youssef","year":"2021","journal-title":"Br J Clin Pharmacol."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1186\/1472-6963-13-470","article-title":"How are population-based funding formulae for healthcare composed? 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A prospective observational study protocol.","author":"M Patel","year":"2025","journal-title":"Research Square."}],"container-title":["NIHR Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/5-125\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/5-125\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/5-125\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T04:59:08Z","timestamp":1776661148000},"score":1,"resource":{"primary":{"URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/5-125\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":15,"URL":"https:\/\/doi.org\/10.3310\/nihropenres.14182.2","relation":{"has-version":[{"id-type":"doi","id":"10.3310\/nihropenres.14182.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.3310\/nihropenres.15571.r40326","asserted-by":"subject"},{"id-type":"doi","id":"10.3310\/nihropenres.15571.r40327","asserted-by":"subject"},{"id-type":"doi","id":"10.3310\/nihropenres.15571.r40326","asserted-by":"object"},{"id-type":"doi","id":"10.3310\/nihropenres.15571.r40327","asserted-by":"object"}]},"ISSN":["2633-4402"],"issn-type":[{"value":"2633-4402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]},"assertion":[{"value":"Indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/5-125\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.3310\/nihropenres.15571.r40327, Victoria Pratt, Indiana University School of Medicine, Indianapolis, Indiana, 11 Apr 2026, version 2, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/5-125\/v2#referee-response-40327","order":0,"name":"referee-response-40327","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.3310\/nihropenres.15571.r40326, Andrew Somogyi, Faculty of Health and Medical Sciences, Adelaide, 20 Apr 2026, version 2, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/5-125\/v2#referee-response-40326","order":1,"name":"referee-response-40326","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This project is funded by the National Institute for Health Research (NIHR) under its Biomedical Research Centre (BRC) Programme (Grant Reference Number NIHR 203956)]. This project is also funded by the National Institute for Health Research (NIHR) under its Research Career Funding - Doctoral Fellowship (DRF) Programme (Grant Reference Number NIHR 301748). \r\nThe views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.\r\nThis study was funded by the NHS England Genomics Programme through the Pharmacogenetics and Medicines Optimisation Network of Excellence. \r\nAdditionally, JHM and WN are supported by Innovate UK (10058536). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}