Collaborations with Community Researchers
Mayo Clinic Psychopharmacogenomic Study
In 2010 we collaborated with Mayo Clinic to evaluate the benefit of using a pharmacogenomic report to guide psychiatrists’ selection and dosing of medications for clients diagnosed with Major Depressive Disorder (MDD). Pharmacogenomics is the branch of pharmacology that correlates an individual’s genetic profile with their response to a drug's efficacy or toxicity. Thus, pharmacogenomics aims to optimize drug therapy, with respect to the patients' genotype, to ensure maximum efficacy with minimal adverse effects. This approach is the basis for “personalized medicine" in which drugs and drug combinations are optimized for each individual's unique genetic makeup.
This study used DNA from a cheek swab, collected by Mayo’s on-site researcher. The swab was then sent to a lab for testing. The lab determined the client’s genetic profile and using an algorithm produced an interpretive report indicating which antidepressants would have the greatest likelihood of success for that client. Fifty one clients with MDD were recruited for the study, with 26 in the comparison group and 25 in the intervention group. The comparison group comprised those clients in which the interpretive reports were not shared with the prescribing psychiatrist until 8 weeks into treatment. This established a baseline of care at Hamm Clinic. The intervention phase followed and comprised clients whose interpretive reports were shared with the psychiatrists prior to treatment to determine whether having additional information impacted the client’s recovery.
Results indicated that the reduction in depressive symptoms achieved in the intervention group was greater than the reduction of depressive symptoms in the comparison group. An article entitled ‘Using a Pharmacogenomic Algorithm to Guide the Treatment of Depression’ has been submitted for publication and is currently under review.
Right Question Project-Mental Health
In 2009 and 2010, we collaborated with Harvard University and University of Minnesota researchers on the Right Question Project. The Right Question Project-Mental Health (RQP-MH) is a three-session health education intervention that teaches clients to participate effectively in mental health care. The methodology teaches clients to identify important issues of their illness or treatment, formulate questions, and devise plans to communicate and act in effective ways that address factors impacting their mental health care. The expectation is that clients’ increased assertiveness and greater involvement in mental health care decision making will increase patient-provider communication and improve the therapeutic alliance between patient and provider. The investigators hypothesize that participants receiving the intervention will be more likely to engage and remain in mental health care, and that they will report higher activation and self-management scores as compared to control patients.
The study is a randomized control trial that began in 2008 and is estimated to be complete in 2012. It is funded by the National Institutes of Health. Data collection sites include mental health care facilities in Minnesota, New York, New Jersey, Boston, North Carolina, and Puerto Rico.