Revolutionary trial to tailor medication

A multi-site research project across four NSW residential aged care homes will see The University of Sydney, myDNA, Choice Aged Care and Arrotex Pharmaceuticals partnering with Whiddon in the first trial of its kind in Australia.

The two-year research study – which is set to commence in September 2024 – showcases a significant development in utilising pharmacogenomics to tailor prescribed medication based on individual genetic profiles.

Two hundred residents will undertake non-invasive cheek swabs that will be tested by myDNA to reveal their individual genotype in order to better guide Doctors and pharmacists when prescribing medications. The main objective of the study is to minimise disadvantageous medication events and improve aged care residents’ quality of life.

With over one million older Australians taking five or more regular medicines, this trial could be a groundbreaking.

Whiddon Deputy CEO, Alyson Jarrett told Australian Ageing Agenda that many of these hospitalisations are due to conditions like dementia, falls, and respiratory issues, all of which are frequently linked to adverse drug reactions.

“By integrating PGx into aged care settings, the study could help prevent a significant portion of these hospitalisations, improving residents’ quality of life and reducing healthcare costs,” Ms Jarrett said.

“The study aims to analyse the financial feasibility and potential benefits of integrating pharmacogenomic testing into the aged care setting. The primary goal is to provide detailed information of the costs, advantages and key considerations associated with the adoption of pharmacogenomic testing in the healthcare management of older people.”

Ms Jarrett said that the “urgent need” for this study to take place lies in its “potential to improve the safety and wellbeing of a vulnerable population” while also “demonstrating the long-term cost savings” associated with pharmacogenomic testing in aged care.

“This is a low-risk study with a detailed protocol that has been developed and approved by the University of Sydney ethics team,” she said.

“We can confirm the relevant education, consent and privacy considerations are in place.”

Previous reports have found that up to half of RAC residents had been prescribed one or more potentially inappropriate medications, with over 90 per cent of residents experiencing at least one medication-related problem.

Dr Sophie Stocker from the School of Pharmacy, Faculty of Medicine and Health, University of Sydney who is leading the research program, told AAA that Pharmacogenomics holds “great promise” for older Australians by enabling personalised medication regimens that can reduce adverse drug reactions and improve treatment efficacy.

“This approach is particularly beneficial for managing chronic conditions prevalent in this age group, such as mental health conditions and cardiovascular diseases,” Dr Stocker said.

“However, challenges remain, including the affordability of testing, and the complexity of integrating pharmacogenomic test results into comprehensive care plans. Additionally, the shortage of healthcare professionals trained in pharmacogenomics poses a significant barrier to its widespread implementation.”

Adding, “This clinical trial will help address some of these barriers and thereby improve access to pharmacogenomic testing for older Australians”.

Research suggests up to 96 per cent of individuals in Australia have at least one actionable pharmacogenomic variation, with many residing in the genes responsible for metabolising commonly prescribed medications.

Ms Jarrett told AAA that the study has the potential to “significantly benefit” older Australians, particularly those in Residential Aged Care (RAC) settings.

“Older Australians often face polypharmacy, where the use of multiple medications increases the risk of adverse drug reactions. By tailoring medications to an individual’s genetic profile through pharmacogenomics (PGx), the study can help reduce the risk of incorrect dosing and adverse events, which is especially crucial in this age group,” she said.

“By improving the precision of medication prescribing, the study can enhance the safety and wellbeing of older Australians, leading to better health outcomes and reduced medication-related harm.”

The results of the study, which have been approved by the University of Sydney Human Research Ethics Committee, are expected to be concluded mid-2026.

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