LB-009 - LEVERAGING CPIC LEVEL 1A PHARMACOGENOMICS INSIGHTS TO MITIGATE ADVERSE DRUG EVENTS IN OLDER ADULTS: EVIDENCE FROM VIRGINIA ALL-PAYER CLAIMS DATABASE 2016-2020.

O. Babatunde¹, A. Okpeku², R. Dixon², S. Hashimi², K. Alrajeh², E. Price²; ¹Virginia Commonwealth University, Virginia Commonwealth University, USA, ²Virginia Commonwealth University, Richmond VA, USA.

Background: Adverse drug events (ADEs) significantly impact older adults, with CNS-active medications and polypharmacy increasing hospitalization risks. Pharmacogenomics (PGx) and CPIC Level 1A guidelines offer evidence-based strategies to optimize drug therapy, yet real-world implementation remains limited. This study uses Virginia’s All-Payer Claims Database (APCD) to highlight the need for PGx-informed prescribing by quantifying the prevalence of actionable medications and identifying opportunities for PGx-guided interventions to enhance safety and efficacy in older adults.

Methods: Data from the Virginia APCD, a comprehensive source of de-identified healthcare claims, were analyzed for individuals aged 65–94 years who were prescribed medications within 45 days prior to hospitalization. Data from 2016–2020 were used to avoid confounding effects from the COVID-19 pandemic and ensure a representative picture of ADE trends. Amazon Quick Sight was used to model prescription (Rx) patterns across different age cohorts (65–74, 75–84, 85–94). Total Rx counts were calculated, and PGx-actionable medications were mapped to CPIC Level 1A gene-drug interactions, with a focus on CNS-active drugs.

Results: From a total of 23,980,368 Rx, 2,267,434 (9.5%) were identified as CPIC Level 1A PGx-actionable Rx, highlighting the significant presence of medications with strong PGx implications in this population. Of the total CPIC Level 1A 42 drugs (2,267,434 Rx), 22 of these drugs (773,704 Rx) were CNS-active medications. An analysis of CNS-active medications revealed that approximately 99% (768, 383Rx) of these drugs had geriatric recommendations within the Beers Criteria, indicating their potential to be inappropriate for older adults. These findings emphasize the need for PGx-informed prescribing to mitigate adverse drug events that could occur in older adults.

Conclusion: This study highlights the significant prevalence of CPIC Level 1A PGx-actionable medications in hospitalized older adults, with CNS-active drugs playing a major role in ADE risks. Using Virginia APCD data from 2016–2020, the findings underscore the urgent need for PGx-informed prescribing to reduce preventable ADEs and improve therapeutic outcomes. These results advocate for integrating PGx testing into routine care to enhance medication safety and precision medicine.