My week was not super eventful, but I will still share it with you (partly because I have to). This week we had our first patient come back in for their post-90 day survey so that they could conclude the study. All of the patients have a strong interest in finishing the study, because if they do not follow through with it then they get charged something like $1000 because their insurance will only cover it if they finish the study. So, that's pretty cool. I was not actually at my site the day the person came in, but I got to look at the survey that the patient fills out when they come back in and I got to input that data into the same system where I inputted the pre-PGX data. Maybe next week I will be able to take a picture of an example survey but for now I will just describe it to you. Basically, the patient describes the condition that has been causing them harm/discomfort and that information is recorded. Then the patient describes the new medication that was prescribed to them and says whether or not it worked better as a treatment than the previous drugs that they used. That's pretty much it. Not that complicated. All of the post-PGX data is compiled into a system designed by the company administering the study and then their researchers compile and analyze that data.
Oh, also I have pictures of what the results look like for the test and what the patient sees! Its a practice trial, so don't worry it's not a HIPAA violation (probably).
Okay, so this first picture is just one of several pages where it gives a list of drugs associated with helping with certain kinds of illnesses (on this page it shows cardiovascular and diabetes). Based on the patient's genes it gives a detailed list of what drugs are ok to take and which ones are not. Every drug in the column titled "Standard Precautions" is ok for the patient to take. Every drug in the column titled "Use with Caution" will most likely react poorly in the patient's body and the drugs in the column titled "Consider Alternatives" are the drugs that the patient can take instead of the drugs in the "Use with Caution" column. Now that's pretty neat!
This second page is the actual results from the analysis of the genes. There are twelve genes listed here and next to each one it describes the genotype and phenotype of the patient with respect to that gene. For the gene CYP2C9, for example, it tells us that the patient is a normal metabolizer for drugs that rely on enzymes created by the CYP2C9 gene to function. This second page is very interesting to me and will be the focus of my future inquiries into how exactly the testing works. I have been doing some studying on my own to try to understand better how these 12 genes operate and how these 12 genes affect enzymatic activity. Once I achieve a better understanding of these phenomena, I will share it in a blog post. Maybe even next week! Well, I hope this post was enlightening. Have a good week/weekend/whenever you get around to reading this. Bye!
Oh, and here's a gif.
Hi Jack, it doesn't seem like your week was uneventful at all! I guess compared to the mouth swapping experience last week, but I got to learn a lot more about your project. Those pictures were super helpful! Based on the picture, it seemed like every category and class of drugs had at least one drug in the standard precautions column. If those are all safe to use, what is the purpose of the "consider alternatives" column.
ReplyDeleteHey Justin! Great question! The list of drugs is just as much for the doctor as it is for the patient so it is there to kind of guide the doctor in what they should prescribe ad to prevent them from prescribing the wrong thing. I think the main purpose of the alternatives column is to narrow down the list of medications that will work for the patient.
DeleteHey Jack! Sounds like a pretty chill week. So being that the patients would have to pay like a crazy fine if they don't complete the trial, what happens if the new medication has no positive results? Or what if the results are even worse than the original medication?
ReplyDeleteHey Alexis! So, the patient in no way is being forced to keep taking a medication that gives them negative side effects. Finishing the study just means coming back in for the survey after 90 days. If the new medication does not work for the patient then they do not have to keep taking it.
DeleteYo Jack, I had a somewhat mellow week as well. But it seems to me that you still had some great work to do. How accurate or what caution does someone need to take when prescribing medication to a patient. Since it is based on gene data, how effective are the results?
ReplyDeleteYo Spencer! Until more post-PGX data comes in, we won't really be able to tell how effective the results are, but we have some idea that based on the patients genes that the new medication will most likely work better for the patient. I will keep you updated though as more patients come in to finish the study!
DeleteI really enjoyed your examples, and you explained it perfectly. Good job making such a complex subject easy to understand.
ReplyDeleteThank you Mr. Carey! I will try my best to keep everything easy to understand even if I don't completely understand it yet!
DeleteHi Jack! Glad to see your swabbing days are behind you. Once again, your deadpan humor makes the blog post a blast to read, and gives life to what you make sound like a pretty slow couple of weeks! When (or if) other patients come back in, do you have any specific duties that you need to perform to help them through the process? Also, can you see and help figure out what medicine is best, or is that more of a doctors-only field?
ReplyDeleteHey Dalton! Glad to hear that we have the same sense of humor! I don't really get to handle the survey when patients come back in, because Carol doesn't take the survey, some nurse practitioner who I don't know does. But, it doesn't take that long and they are just asked a few simple questions. In regards to figuring out which medicine is best, that's a doctor's task, because they are much more familiar with the drugs and medical history and stuff.
DeleteHi Jack! Sorry to hear it has kinda been a slow week for you. It is good though that next week you will probably get more information to deal with. I was wondering, if the new medication fails, then will the patient get a third medication? I hope the best for your project!
ReplyDeleteHey Sam! If the new medication fails, then it is kind of up to the patient's general practice doctor/Dr. Lalani if they are going to try another new medication. It kind of varies on a case by case basis so I can't really give you a straight answer.
DeleteHey Jack. Loved the gifs you used this week. Anyways, I was wondering if each patient receives a specialized report about what alternative medications they can use if their prescribed ones don't work based on their genes or if there is just a general list based on the medications they already take? Thanks and can't wait to read more about your findings.
ReplyDeleteHey Anisha! Every patient receives an individualized report detailing the drugs that will not work for them and their alternatives.
DeleteHi Jack! Sorry that your week was slow. I'm really interested about what is so special about those 12 genes in determining the right medication for a patient! Are the questions on the survey general, or do they get very specific about the details? Also, out of curiosity do you pronounce 'gif' with a hard 'g' or like 'jif'? I look forward to reading your next post!
ReplyDeleteHey Dhanya! So, those specific 12 genes code for enzymes that metabolize most of the common drugs prescribed by doctors. The questions are pretty general. Basically just asking did the medication work better than your previous ones. I pronounce it with a hard g. I know its technically supposed to be pronounced jif but I just can never bring myself to say it like that.
DeleteHi Jack! I liked the fact that you still had your humor even in this slow week. I'm curious if these documents are stored in a computer database or as physical documents? Hope you have a great rest of your day!
ReplyDeleteHey Zak! We do both. We take the surveys by hand and then stack them in a binder. Then, I input all of the information into a computer database.
DeleteHey Jack! Its sucks that this week was slower, but it happens! I found it intriguing that you included the paperwork that you see, as I can clearly see what your process is. Keep up with the good work!
ReplyDeleteThanks Lindsey! I am glad that you are enjoying the blog posts!
DeleteLove your gifs! That's a super great incentive to complete the survey! I hope you're having a ton of fun! Do you get to listen to music at your internship? And also, I am super excited that you guys are getting results already!
ReplyDeleteHey Lauren! I am sure that I probably could listen to music since I am just sitting at a computer the whole time but I have yet to do so. That is a pretty good idea though. And yeah getting results already is exciting! I will keep you updated!
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