About the Project
The PGx4Dep project ran from 2020 to 2023. Check out our Publications and Presentations page to see our results. To learn more about our methods and the different parts of the study, read on!
Our work involved reviewing research that others have already done, as well as conducting interviews with patients, doctors, nurses, pharmacists, counsellors, and others to see what they think about pharmacogenomic testing for depression care. We used this information, along with administrative data from BC health records, in a computer simulation model. The simulation model includes thousands of hypothetical patients, and it is designed to assesses the health outcomes and costs associated with pharmacogenomic testing.
Background Information
Major depressive disorder (MDD) is a common mental health condition for which there are many effective treatments. Antidepressant medications are often used to treat MDD and there are many different antidepressants to choose from. As it currently stands in BC, finding a medication that is effective and that does not cause side effects is a matter of trial-and-error. People with MDD may undergo several trials before finding an antidepressant that fits these criteria, as people respond differently to different medications.
The differences in how people respond to medications are thought to be partially determined by our genes. A new and promising approach called “pharmacogenomic testing” is designed to see if an individual’s genetic makeup is suitable for a particular drug.
In this study, we wanted to know if pharmacogenomic (PGx) testing should be routinely used in BC when caring for people with depression. We wanted to know if it will improve patient health overall, and see if the testing is good value for money for the health system.
Project Components
Activity 1 – Patient and healthcare professional perceptions and experiences of pharmacogenomics
Purpose: to understand patient and healthcare professionals’ perceptions of and previous experiences with pharmacogenomics (PGx) testing. We also want to know what they will identify as barriers and facilitators to implementation. These data will allow us to identify potential stakeholder views whose data is important to incorporate into the simulation model (Activity 3).
Activity 2 – Environmental scan and rapid review of pharmacogenomics for depression
Purpose: to examine the clinical- and cost-effectiveness of PGx testing in helping to determine appropriate pharmacotherapy for patients with depression. In cases where existing administrative data is not available or suitable, these data will be incorporated into the simulation model (Activity 3).
Activity 3 – Simulation model development and model-based economic analysis
Purpose: to develop a simulation model (i.e., a microsimulation-Markov model) of care pathways for people with depression in BC. This model will provide the analytic infrastructure and deliver predictions of the benefits and costs associated with PGx tests for people with depression in BC.
Check out our video, produced in collaboration with the Peer Models Network, to learn more about the model!
Activity 4 – Administrative data collation and analyses
Purpose: use existing administrative and clinical datasets from Population Data BC to select a cohort of patients with depression. We will look at demographic characteristics, prescriptions for antidepressants, health services used/accessed (e.g., hospital admissions, number of GP appointments), and costs. Such data will be available to populate and tailor the simulation model specifically to the BC context.
Activity 5 – Ongoing stakeholder and end-user engagement and multi-stakeholder dialogue event
Purpose: engage relevant stakeholders using varying methods of consultation and involvement according to the different groups, their roles, and the activities of this project. This forms an integrated-knowledge translation approach, which means it is conducted throughout this project.