Pharmacogenomics-Supported Psychotropic Prescribing Trial

Background and Rationale: Pharmacogenomic (PGx) testing utilizes genetic information as a surrogate marker of a person's ability to process and react to drugs. This information can be used to inform medication selection and dosing, reducing the number of trials needed to choose a suitable medicine. For Manitoba healthcare providers, the only access to psychiatric PGx testing is through commercial providers, costing patients $200 to $2,300. To the best of our knowledge, no study in Manitoba has previously evaluated the feasibility of PGx testing in adult patients seeking care for mental illness.

RESEARCH OBJECTIVES: We aim to investigate the feasibility and utility of implementing PGx testing in Manitoba for adult patients seeking care for mental illness.

Primary Outcome and Measures: Feasibility will be measured along four dimensions:

* Acceptability (satisfaction surveys - patient \& clinician) * Practicality (testing turnaround time) * Implementation (clinicians' self-reported use of testing results in the prescribing decision-making process) * Demand (number of referrals, clinicians' self-reported intent to use testing in the future)

Secondary Outcomes and Measures:

* Changes in global functioning and symptom severity \[Clinical Global Impression (CGI) - Severity and Improvement; Brief Psychiatric Rating Scale (BPRS); DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure; Patient Health Questionnaire-9 (PHQ-9); General Anxiety Disorder-7 (GAD-7); Altman Self-Rating Mania Scale (ASRM); Early Psychosis Screener (EPS-26)\] * Adverse drug experience \[Frequency, Intensity, Burden of Side Effects Rating (FIBSER)\] * Impact of PGx testing \[Changes in medication prescribing and dispensing patterns; changes in healthcare utilization (e.g., inpatient length of stay, mental health resource use, and utilization of healthcare services)

Expected Outcomes: The findings from the proposed study will inform policymakers and facilitate decision-making and priority-setting related to implementing PGx-based psychotropic prescribing policies in Manitoba

• Clinical Global Impression Scale (CGI) - Severity [Срок оценки: Baseline]
• Clinical Global Impression Scale (CGI) - Improvement [Срок оценки: 3 months after baseline.]
• Brief Psychiatric Rating Scale (BPRS) [Срок оценки: Baseline and patient discharge date, within 3 months.]
• DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure - Adult [Срок оценки: Baseline and 3 months after baseline.]
• General Anxiety Disorder-7 (GAD-7) [Срок оценки: Baseline and 3 months after baseline.]
• Patient Health Questionnaire-9 (PHQ-9) [Срок оценки: Baseline and 3 months after baseline.]
• Altman Self-Rating Mania Scale (ASRM) - Adult [Срок оценки: Baseline and 3 months after baseline.]
• The Early Psychosis Screener (EPS-26) [Срок оценки: Baseline and 3 months after baseline.]
• Frequency, Intensity, Burden of Side Effects Rating (FIBSER) [Срок оценки: Baseline (if applicable) and 3 months after baseline.]
• Healthcare Utlization [Срок оценки: 1 year]