FAQ

Frequently Asked Questions - Patients

Why is the pharmacogenomic test performed?

Your PGx results can be used by your physician to make your medical therapy more personalized. Based on your PGx results you may receive a smaller or higher dosage of a certain drug or your physician may prescribe you a different drug substance because you are at higher risk for adverse drug reactions.

How is the test performed?

Once a patient decides to enter the study he or she will be asked for a blood draw or a saliva sample. From this blood or saliva we are able to perform the PGx test.

How will my test results be used in my care?

If you are in the genetic test group, your results will be returned to your doctor or pharmacist within 3 working days. After this time, your doctor or pharmacist may contact you with your personalized prescription – which may be a different dosage or different drug than you may have received when you started you medication. In the time between your blood or saliva collection and the personalized prescription, your doctor will prescribe your medication as he or she usually does (without taking your DNA into account) so that there is no delay in treatment. Additionally, you will also be given a card on which your DNA results will be printed. You will be asked to show this card to all doctors and pharmacists during the study. They may be able to use your results to personalize additional new prescriptions.

Do my PGx test results also tell about the risk for developing certain diseases?

No, the PGx variants tested in the context of PREPARE focus solely on estimating how you will respond to certain medications.

Will the PGx test need to be repeated like other tests, e.g. for cholesterol level?

No, PGx test results have lifelong validity. Your PGx test results can be used to optimize your therapy throughout your entire lifespan whenever a relevant medication is prescribed.

How can I participate in the study?

Unfortunately, it is not possible to include you in the study on request. Only patients who receive a first prescription of one of the drugs relevant to the study during their treatment at one of the participating institutions and who fulfill all other inclusion criteria will be contacted by their local study team.

I was assigned to the standard of care group. Will I get access to my PGx results?

If you are in the standard of care group, you will receive your test results only once the study is complete. This means that your doctor will prescribe your medication as he or she usually does (without taking your DNA into account). If you wish, you will also receive a card that contains an overview of your PGx results once the study is finished.

What is the safety-code card?

The safety-code card is a pocket card that contains a quick overview of your PGx test results. Furthermore, the card contains a QR code that can be scanned by you or your healthcare provider with, e.g., a smartphone to quickly retrieve PGx-based dosing recommendations relevant to you. If you were assigned to the study group, your card is handed out to you by your local study team when your PGx test results are ready. Please take care of this card, and don’t forget to show it to your healthcare provider every time you receive a new prescription. If you were assigned to the standard of care group, you may receive your safety-code card once the study is finished. For more information on the safety-code card, please visit http://www.safety-code.org.

Frequently Asked Questions – Professionals

What is the study design of PREPARE?

What is the study design of PREPARE?
PREPARE is designed as a multi-center, open, randomized, cross-over study. The sequence of study and control arm is randomized per country to minimize the influence of time dependent variables.

The 7 participating countries were randomized to start with:
1) Implementing pre-emptive PGx testing to guide drug and dose selection (study arm): Greece, Slovenia and Spain
2) Providing standard clinical care (control arm): Netherlands, Austria, Italy and UK

How are patients recruited?

Patients who receive a first prescription for any of the drugs relevant to the study during their treatment at one of the participating institutions and who fulfill all other inclusion criteria are contacted by their local study teams.

Which drugs are relevant to PREPARE?
Therapeutic group Generic name
Antiarrhythmic Flecainide
Propafenon
Analgesic Codeine
Oxycodone
Tramadol
Anticancer Capecitabine
Fluorouracil
Irinotecan
Tamoxifen
Tegafur
Anticoagulation Acenocoumarol
Clopidogrel
Phenprocoumon
Warfarin
Antidepressant (SSRI) Paroxetine
Sertraline
Venlafaxine
Citalopram
Escitalopram
Antidepressant (TCA) Amitriptyline
Clomipramine
Doxepine
Imipramine
Nortriptyline
Antiepileptic Carbamazepine
Phenytoin
Antihypertensive Metoprolol
Anti-infective Efavirenz
Flucloxacillin
Voriconazole
Antipsychotic Aripiprazole
Clozapine
Haloperidol
Pimozide
Zuclopenthixol
Cholesterol – lowering Atorvastatin
Simvastatin
Immuno – suppressive Azathioprine
Mercaptopurine
Tacrolimus
Thioguanine
Other Atomoxetine
Oestrogen containing drugs *

* only if a 2nd prescription, not for primary inclusion

How is the test performed?

Patients are asked to provide a blood or saliva sample which is analyzed for over 40 variants across 13 important PGx genes. Genotyping is performed with an array specifically designed for the PREPARE study using the LGC SNPline platform.

Which guidelines are used to tailor a patient’s therapy to his or her PGx results?

In the PREPARE study, pharmacogenomic dosing guidelines authored by the Dutch Pharmacogenetics Working Group (DPWG) are used for PGx-based prescribing. To assist healthcare providers in using their patients’ PGx results to optimize their therapy, all recommendations relevant to the individual patient are included in the their written PGx report. Furthermore, all relevant recommendations can be accessed by healthcare providers via scanning the QR code of the personal safety-code card that each patient assigned to the study group receives.

What is the safety-code card?

The safety-code card is a pocket card that is handed out to all patients assigned to the study group and that contains a quick overview of his or her PGx test results. Furthermore, the card contains a QR code that can be scanned by healthcare providers with, e.g., a smartphone to quickly retrieve PGx-based dosing recommendations relevant to the respective patient. In the context of PREPARE, the safety-code card serves as an auxiliary tool to maximize the accessibility and sharing of PGx results within and between different healthcare settings and healthcare professionals. For more information on the safety-code card, please visit http://www.safety-code.org.