16 research outputs found

    A European spectrum of pharmacogenomic biomarkers: Implications for clinical pharmacogenomics

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    Pharmacogenomics aims to correlate inter-individual differences of drug efficacy and/or toxicity with the underlying genetic composition, particularly in genes encoding for protein factors and enzymes involved in drug metabolism and transport. In several European populations, particularly in countries with lower income, information related to the prevalence of pharmacogenomic biomarkers is incomplete or lacking. Here, we have implemented the microattribution approach to assess the pharmacogenomic biomarkers allelic spectrum in 18 European populations, mostly from developing European countries, by analyzing 1,931 pharmacogenomics biomarkers in 231 genes. Our data show significant interpopulation pharmacogenomic biomarker allele frequency differences, particularly in 7 clinically actionable pharmacogenomic biomarkers in 7 European populations, affecting drug efficacy and/or toxicity of 51 medication treatment modalities. These data also reflect on the differences observed in the prevalence of high-risk genotypes in these populations, as far as common markers in the CYP2C9, CYP2C19, CYP3A5, VKORC1, SLCO1B1 and TPMT pharmacogenes are concerned. Also, our data demonstrate notable differences in predicted genotype-based warfarin dosing among these populations. Our findings can be exploited not only to develop guidelines for medical prioritization, but most importantly to facilitate integration of pharmacogenomics and to support pre-emptive pharmacogenomic testing. This may subsequently contribute towards significant cost-savings in the overall healthcare expenditure in the participating countries, where pharmacogenomics implementation proves to be cost-effective

    Primary care in Baltic countries: a comparison of progress and present systems.

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    Objectives: This study aims to compare the organisation of primary care (PC) systems in Estonia, Latvia and Lithuania, focusing on the structure and process of service delivery, and to discuss the suitability of the PHAMEU instrument for international comparison of PC systems. Methods: The data were collected in the framework of PHAMEU project during 2009–2010. The selected indicators were used to describe and compare the structure and process of PC in Estonia, Latvia and Lithuania. Results: The results showed that the coordination of PC services, legislative framework, service delivery, quality requirements and PC financing principles are rather similar in all three Baltic countries. Population coverage for PC services, cost sharing for some services, and the employment status of family doctors differs by country. The PHAMEU instrument was most applicable for the description and comparison of the structure of PC and some aspects of the process. Information about patient outcome and quality of care was neither available nor reliable enough. Conclusion: The development of PC systems in Baltic countries has been rather similar, but some aspects also differ between the countries. Use of a standardized instrument allows for international comparison, but assumes standardised data collection procedures in comparable countries. (aut.ref.
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