The Covid-19 pandemic has impacted the quality of care, access to healthcare providers, and has driven a greater than ever demand for mental health professionals in the modern medical field. To slow the spread of Covid-19 and meet acute care needs due to the number of Covid-19 cases, overall maintenance and monitoring care was delayed or abandoned between March 2020 and March 2021, resulting in currently undertreated patients Backlog.
Mental health needs surge
The biggest healthcare need related to Covid-19 is mental health. National statistics prove that the impact of the pandemic on lives, routines and isolation is the greatest need for mental health professionals. There is currently a shortage of mental health professionals, limiting time with each patient, and long waiting lists for care. Click image to enlarge.
Image courtesy of Statista
Trial and error is not the most effective way to find the best treatment in cases where drugs can help relieve or address an immediate mental health disorder. Four out of 10 people treated with antidepressants improved after taking the first drug. Mental health providers and patients do not have the time or luxury to cycle through prescribed treatments to find treatments that meet the unique needs of individual patients. Mental health professionals and patients need effective solutions to point to medications they know will work from the start.
Precision prescribing is a new clinical trend that brings together patient-related data points such as current medical condition and comorbidities, liver and kidney function, previous drug treatments and drug interactions, and also takes into account the patient’s genomic makeup or its pharmacogenetics Genetic characteristics. Pharmacogenetic (PGx) tests can help understand how likely a patient is to respond to a drug—from the start or if they will experience side effects—by assessing a patient’s genetic profile. The PGx Psychiatric Drug Test is currently available for medications to treat bipolar disorder, depression, obsessive-compulsive disorder (OCD), schizophrenia, and more. In some advanced clinics, the use of these modern tools to incorporate pharmacogenetics into the decision-making process is the preferred standard of care for some specific situations and in some specific drug use.
How Mental Health Precision Medicine Works
Most antidepressants/antipsychotics are metabolized by enzymes in the liver. Due to the close relationship between pharmacogenetic variation and enzyme activity, analysis of key enzymes has been an early focus of clinical application of PGx in psychiatry.
For example, in one study, the response rate to initial antidepressant treatment was only 49.6%, and a systematic review showed that patients who did not respond to one or more treatments were 15% more likely to have suicidal ideation, whereas those receiving treatment 6% of patients. Reactive depression and 1% of the general population (Mrazek et al. 2014).
Other studies have shown that up to 43% of people with major depressive disorder may discontinue antidepressants due to treatment-emergent side effects. A major determinant of side effects and lack of efficacy is the relationship between dose and systemic exposure of the drug.
There are two key challenges in optimizing the utility of the PGx test for precise prescribing:
- Test results and information must be available at the point of care, and
- This information must be provided in an effective and actionable manner for truly personalized care.
Precision prescribing platforms could significantly alleviate some of the challenges posed by shortages of mental health professionals; improve patient treatment, safety, and satisfaction; and reduce the financial burden on healthcare systems.
How to Implement Precision Prescribing in Your Healthcare System
Several testing companies offer PGx testing, but implementing a platform that provides evidence-based precision medicine management at the point of patient care may have the greatest utility and optimize care efficiency.
While most providers are currently practicing reactive medicine, the shift toward predictive medicine enhanced by PGx can help patients be more successful in managing mental health issues. There are now technologies that can predict a patient’s response to treatment or the risk of developing the disease. When this PGx data is considered along with other well-known factors that affect an individual’s response to the drug (eg, kidney function, liver function, comorbidities, etc.), it can help clinicians identify personalized plans to avoid or delay in relation to the condition or treatment onset of disease or complication.
Leveraging a precise prescribing platform with embedded genomic analysis will help physicians improve care and reduce costs by providing valuable information to inform mental health drug choices that provide patients with treatment success from the start. This will fundamentally disrupt and digitally transform centuries of prescription, trial-and-error methods into methods that increase efficiency and accuracy when we need it most.
Photo: Vacharapong, Getty Images
