New collaboration aims to prevent life-threatening adverse reactions to medications

Reviewed by James Ives, M.Psych. (Editor)Feb 27 2019

The University of Arizona College of Medicine - Phoenix and Banner Health are collaborating to prevent life-threatening adverse reactions to medications.

The Flinn Foundation awarded the Division of Clinical Data Analytics and Decision Support (CDADS) at the UA College of Medicine - Phoenix $1.5 million, which is being matched by Banner Health with in-kind staff salaries and resources, to incorporate pharmacogenomics and clinical decision support into clinician training and medical practice.

Pharmacogenomics combines pharmacology, the science of drug actions, with genomics, the study of genes, to predict an individual's response to specific drugs. The goal of pharmacogenetics is to enable physicians to choose effective, safe medications and doses tailored to a person's genetic makeup.

"The Flinn Foundation grant is the result of several years of planning by the UA College of Medicine - Phoenix to incorporate precision medicine into the curriculum and into faculty research programs," said Raymond Woosley, MD, PhD, co-director of the Division of Clinical Data Analytics and Decision Support.

"The integration of these two fields has the potential to save lives by mitigating risks commonly associated with medications and devices," said UA President Robert C. Robbins, MD. "This is the perfect example of how precision medicine is the future of health care and why the University of Arizona is focused on remaining at the forefront of this important work. The UA's history of interdisciplinary collaboration gives us an edge in conducting this research and in bringing these new approaches to clinician training, in partnership with Banner Health. The program is a testament to the great work being done by our passionate clinicians and researchers."

Four groups initially will be targeted with risk prediction and clinical decision tools:

• Patients susceptible to drug-induced Long QT Syndrome, a condition in which medications slow the relaxation phase of the heart beat and thereby predispose them to potentially lethal heart rhythm disorders.
• Patients susceptible to Heparin-Induced Thrombocytopenia, an adverse reaction to the anti-coagulant heparin that can lead to life-threatening blood clots such as deep vein thrombosis or a pulmonary embolism.
• Patients receiving mechanical respirator therapy, so that optimal airway pressure can be maintained and thereby prevent ventilator-induced lung injury.
• Patients who inherit high-risk genetic variations in one or more genes that regulate the metabolic breakdown of drugs and thereby affect patients' responses to therapies.

For detailed information on each project, please go to http://phoenixmed.arizona.edu/clinicaldata/projects.

"Since its beginning, the overall support for the collaboration has included a significant commitment from Banner Health to provide staff to work with UA faculty members and to give the team access to the clinical data required for their work," said Larry Goldberg, president of Banner - University Medicine. "Banner Health is eager to see this program continue to grow, and we are especially pleased that this application will focus on the clinical implementation of pharmacogenetics testing and its integration into clinical decision support systems."

"These projects show the importance of the collaboration between College of Medicine - Phoenix faculty members and Banner Health," Dr. Woosley said. "Our faculty and Banner Health physicians will be able to deliver precision medicine because of this investment by the Flinn Foundation that unites modern information technology and genomics. This enables our faculty members to teach UA students to deliver the right medicine, at the right time, for the right patient."

Co-directed by Dr. Woosley and Steven Curry, MD, the Division of Clinical Data Analytics and Decision Support provides timely, targeted, meaningful data analytics and clinical decision support systems for research, medical care and quality improvement at the College and Banner Health.

"Establishing this program in the Banner Health system is only the beginning of applying what Dr. Woosley and Dr. Curry have created with their colleagues at the UA College of Medicine - Phoenix," said Tammy McLeod, president and CEO of the Flinn Foundation. "It will serve as a replicable model for health systems across Arizona and beyond, toward a day when all patients will have access to clinical decision support systems and pharmacogenetics testing."

Created in 2016 with initial support from the College and grants from the Flinn Foundation, CDADS has worked with Banner Health to capture and analyze large amounts of data from Banner's electronic medical records.

CDADS and Banner Health clinical scientists use this knowledge, along with health information technology, to create clinical decision support advisories that inform physicians and other health-care providers as they make medical decisions.

With the initial funds, the UA College of Medicine - Phoenix recruited seven faculty members to launch CDADS and created a partnership with the Tucson-based, non-profit Arizona Center for Education and Research on Therapeutics. The partnership was awarded a three-year contract from the U.S. Food and Drug Administration to develop its first clinical decision support program at the College and Banner Health.