by Flora Bessey, Pharm.D., CGP

There’s been a big push as at least 2 genetic testing companies have entered into the long term care arena. They are actively visiting facilities so you may have already been approached regarding your opinion on genetic testing.  Here is some information that may help you decide the appropriateness for your facility and residents. 

At first glance it may seem appropriate to have everyone at your facility tested to gauge possible effectiveness of their current medications.  After all, it may help you understand why certain medications are not working or the effects are wearing off sooner than expected.

Additionally, CDPH is working on an adverse drug reaction survey tool.  This specifically asks that we outline measures in the patients’ records as to how we are managing adverse effects.  Genetic testing might be a great tool to show how your facility is being proactive with adverse effects management and prevention.  As an example, if we could isolate how certain drugs metabolize slower in patients of a certain genetic makeup, we could limit their risk and exposure to adverse drug events.

Although this seems ideal, the science is not perfect for all medications. If you are having trouble titrating a pain regimen for a patient, this may work for you.  On the other hand, antipsychotics and other psychotropic medications appear to be a grey area.  Often times it is the psychotropic meds we are most concerned about.

In terms of reimbursement, the testing is covered by Medicare part B…for now.  While there is a certain newness to all of this right now, some fear that Medicare may audit facilities, question the appropriateness of testing and seek recompense.  The genetic testing companies are seeking to get out in front of these concerns with a specific form which when filled out properly leaves almost no room for problems.

The field of genetic testing as a tool for healthcare individualization is in its infancy. These new tools as now constituted merely scratch the surface of what we may hope for, now and in the future. If you have specific questions regarding the potential for this technology to improve your facility’s quality of care, please contact your individual company reps.

This definitely seems to be the wave of the future for healthcare in general.  We will have to see how it ends up being used in long term care.

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