Pharmacogenomic Medicine Use and Adverse Outcomes in Hospitalised Older Patients: A Retrospective Cross-Sectional Study
David, Victoria McInerney, C.D. Sagoo, G.S. Cheong, V-L. Smith, H. Rattray, Marcus
David, Victoria
McInerney, C.D.
Sagoo, G.S.
Cheong, V-L.
Smith, H.
Rattray, Marcus
Publication Date
2026-01-01
End of Embargo
Supervisor
Rights
© 2026 The Authors. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Peer-Reviewed
Yes
Open Access status
openAccess
Accepted for publication
2026-01-05
Institution
Department
Awarded
Embargo end date
Collections
Additional title
Abstract
This study aimed to assess the prevalence of the use of medications with pharmacogenomic guidelines upon hospital admission in patients aged 65 and over and evaluate its association with adverse outcomes, including length of stay, unplanned admissions, and repeat hospital admissions. A retrospective cross-sectional study was conducted using hospital admissions data from 2018–2019 in one NHS hospital trust in England, focusing on patients aged 65 and over. The usage of medications with pharmacogenomic guidelines was examined, and comparisons were made between their prevalence in unplanned and planned admissions.
Multivariable models assessed whether the use of medications with pharmacogenomic guidelines were associated with adverse outcomes, considering frailty status. Analysis of 59,973 admissions revealed 67 pharmacogenomics medicines as per the Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines, with 11 classified as high-risk among 1438 unique medicines identified from 560,179 recorded medications. Notably, unplanned admissions exhibited a higher prevalence of medications with pharmacogenomic guidelines (84% versus 64%, p < 0.001) compared to planned admissions. The models demonstrated the usage of these medications was associated with adverse outcomes (length of stay in hospital, unplanned admission and repeat hospital admission) with substantial evidence (Delta_AICc < 2) particularly in patients with high frailty status. This study highlights the association between medications with pharmacogenomic guidelines and adverse outcomes, particularly among patients with high frailty. The findings emphasise the importance of integrating pharmacogenomic-guided care into the management of older individuals with frailty to mitigate adverse outcomes and enhance medication safety.
Version
Published version
Citation
David V, McInerney CD, Tomlinson J, et al (2026) Pharmacogenomic Medicine Use and Adverse Outcomes in Hospitalised Older Patients: A Retrospective Cross-Sectional Study. Pharmacogenomics Journal. 26(1): Article 3.
Link to publisher’s version
Link to published version
Link to Version of Record
Type
Article