Opportunities for Pharmacogenomics in Pediatrics: Prescribing Trends of Psychiatric Medications With Pharmacogenomic Implications at a Multistate Pediatric Health System

The Clinical Pharmacogenetics Implementation Consortium (CPIC) has published guidelines providing pharmacogenomic (PGx) recommendations for more than 100 drugs; however, limited data exist describing prescribing patterns of these medications in pediatric populations. With increasing evidence describing the benefits of PGx testing to tailor drug therapy in psychiatric conditions, along with a worsening mental health crisis in pediatrics, it is vital to assess the prevalence of medication prescribing and potential impact of implementing PGx testing in this population. Here we describe prescribing patterns of psychiatric drugs classified as CPIC level A/B from January 1, 2010, through December 31, 2020, across Nemours Children’s Health, a multistate pediatric health care system. We identified 21,442 unique patients who received at least 1 indicated medication during this period. The most frequently prescribed medications were amitriptyline and sertraline. Overall prescribing was highest in the departments of neurology, primary care, and psychiatry with selective serotonin reuptake inhibitors (SSRIs) being the most frequently prescribed medication class. These findings indicate ample opportunity for PGx implementation targeting these medications. Identification of high-prescribing departments and specific medications prescribed will help focus PGx implementation and education efforts.