January 25, 2023
For people with mental health conditions, finding a medication that works without causing severe side effects is often a matter of trial-and-error. This difficult process can cause people to abandon their treatment, lead to poorer health and increases costs for BC’s health care system.
Pharmacogenomics (PGx) can improve a person’s health by helping them know whether a drug is likely to work for them without triggering an adverse reaction. This has real potential to end the “trial-and-error” approach to therapy. However many questions still need to be answered before this approach can be implemented. In 2020, a $1.5 million project, led by Dr. Jehannine Austin and Dr. Stirling Bryan and supported by funding from Genome BC, Genome Canada and Michael Smith Health Research BC, sought to provide some of those answers by investigating if pharmacogenomic testing should be routinely used in BC for people with depression.
The potential of personalized treatment for depression
Researchers interviewed both people living with depression and health care professionals to explore experiences with PGx testing for depression, as well as perceptions, opinions and attitudes around its potential use in BC. They also reviewed existing studies and information on the subject from BC’s health care system to assess any improvement in patient health, as well as whether the testing provides good value for money spent in the health care system.
“Lots of people are excited about this type of testing, and hope that it will help people recover from depression more quickly,” said Caitlin Slomp, a Genetic Counsellor and the lead author of the study published in The Canadian Journal of Psychiatry. “Our findings can help ensure that if, or when, this testing goes ahead in BC, it’s done in a way that is acceptable, effective and equitable for everyone who may need it.”
Hopes and concerns
The study revealed that patients with lived experience and health care providers had different aspirations and concerns.
Patients expressed hope that the testing could help people find an effective antidepressant faster with fewer side effects, while reducing hospitalizations and the stigma around mental health. “There is a possibility that people will be able to live with hope instead of despair.” said Linda, a patient partner researcher in the study.
Health care professionals desired to improve the patient experience. They conveyed concerns about how to interpret and apply PGx results. The two groups shared unease over the cost of testing and whether people could afford it. Both groups agree that stronger evidence is needed before implementation.
PGx testing has significant potential for delivering precision health care for patients with depression, however there is more work to be done to ensure that implementation into routine clinical care in BC provides efficacy and is cost-effective. Currently, PGx testing is only available through clinical studies, or privately, through workplace benefits, online and select pharmacy partners. It is not covered through the Medical Services Plan of British Columbia.
Read the study here. Watch this short video about the project. Or listen to Dr. Jehannine Austin talk about this research on Genome BC’s podcast, Nice Genes!
If you, or someone you know, needs support, call the BC Mental Health Support Line at 310-6789 or find Canada-wide resources right here.