OAII-001 - EVALUATION OF PHARMACOGENOMIC MEDICATION PRESCRIBING PATTERNS IN RURAL VERSUS URBAN SETTINGS.

A. Radwan¹, C. Roeder², D. Kao³, H. Anderson⁴, J. Martin⁵, E. Woodahl⁶, C. Aquilante⁴; ¹University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, United States, ²University of Colorado School of Medicine, Aurora, CO, United States, ³University of Colorado School of Medicine, , , ⁴University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, , , ⁵University of Colorado Anschutz Medical Campus, , , ⁶University of Montana, , .

Background: To decrease disparities in pharmacogenomic (PGx) testing and advance PGx implementation, it is essential to understand medication prescribing patterns in different settings, particularly rural and underserved communities. The objective of this study was to compare the prescribing frequencies of PGx medications among patients residing in rural versus urban areas in Colorado (CO).

Methods: We conducted a retrospective analysis of adult patients prescribed at least one PGx medication between 1/1/2021 and 12/31/2021 at UCHealth. We evaluated the prescribing frequencies of 105 CPIC level A, A/B, and B medications. Geographic area was ascertained using an individual’s last reported zip code and by assigning Rural-Urban Commuting Area (RUCA) codes. Urban areas included zip codes with RUCA codes of 1-3 and rural areas included zip codes with RUCA codes from 4-10. We used logistic regression to assess the relationship between rural vs urban setting and being prescribed three or more PGx medications during the study period (yes/no), while adjusting for covariates such as, age, gender, race, and ethnicity.

Results: The study included 451,725 patients, with 7.5% residing in rural areas in CO. Compared to urban areas, patients in rural areas were older (mean ± SD=56.3 ± 18.1 vs 51.2 ± 19 years, p< 0.001), more likely to be male (45.6% vs 41.6%, p< 0.001), more likely to be white (88.4% vs 78.3%, p< 0.001), and less likely to be Hispanic (10.6% vs 14.3%, p< 0.001). The mean ± SD number of unique CPIC PGx medications prescribed in 2021 in the overall cohort was 2.2 ± 1.6 (median=2, range=1-17). After adjusting for covariates, residing in a CO rural area was associated with significantly higher odds of being prescribed three or more CPIC PGx medications compared to urban areas (OR=1.29, 95% CI: 1.26-1.32, p< 0.001). The most prescribed CPIC PGx medications in the study cohort were ondansetron, hydrocodone, tramadol, ibuprofen, atorvastatin, and PPIs.

Conclusion: Individuals residing in rural areas in CO had a higher yearly PGx medication burden compared with urban areas, highlighting the potential clinical utility of PGx testing in these communities. Additional studies in other rural settings are needed to corroborate these findings. Together, these data can inform future PGx implementation initiatives in rural populations.