{"doi":"10.3390/jpm12071145","title":"Effect Modification by Social Determinants of Pharmacogenetic Medication Interactions on 90-Day Hospital Readmissions within an Integrated U.S. Healthcare System","abstract":"The present study builds on our prior work that demonstrated an association between pharmacogenetic interactions and 90-day readmission. In a substantially larger, more diverse study population of 19,999 adults tracked from 2010 through 2020 who underwent testing with a 13-gene pharmacogenetic panel, we included additional covariates to evaluate aggregate contribution of social determinants and medical comorbidity with the presence of identified gene-x-drug interactions to moderate 90-day hospital readmission (primary outcome). Univariate logistic regression analyses demonstrated that strongest associations with 90 day hospital readmissions were the number of medications prescribed within 30 days of a first hospital admission that had Clinical Pharmacogenomics Implementation Consortium (CPIC) guidance (CPIC medications) (5+ CPIC medications, odds ratio (OR) = 7.66, 95% confidence interval 5.45−10.77) (p < 0.0001), major comorbidities (5+ comorbidities, OR 3.36, 2.61−4.32) (p < 0.0001), age (65 + years, OR = 2.35, 1.77−3.12) (p < 0.0001), unemployment (OR = 2.19, 1.88−2.64) (p < 0.0001), Black/African-American race (OR 2.12, 1.47−3.07) (p < 0.0001), median household income (OR = 1.63, 1.03−2.58) (p = 0.035), male gender (OR = 1.47, 1.21−1.80) (p = 0.0001), and one or more gene-x-drug interaction (defined as a prescribed CPIC medication for a patient with a corresponding actionable pharmacogenetic variant) (OR = 1.41, 1.18−1.70). Health insurance was not associated with risk of 90-day readmission. Race, income, employment status, and gene-x-drug interactions were robust in a multivariable logistic regression model. The odds of 90-day readmission for patients with one or more identified gene-x-drug interactions after adjustment for these covariates was attenuated by 10% (OR = 1.31, 1.08−1.59) (p = 0.006). Although the interaction between race and gene-x-drug interactions was not statistically significant, White patients were more likely to have a gene-x-drug interaction (35.2%) than Black/African-American patients (25.9%) who were not readmitted (p < 0.0001). These results highlight the major contribution of social determinants and medical complexity to risk for hospital readmission, and that these determinants may modify the effect of gene-x-drug interactions on rehospitalization risk.","journal":"Journal of Personalized Medicine","year":2022,"id":293117,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9459,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":921276,"name":"Lavisha Singh","orcid":null,"position":1,"is_corresponding":false},{"id":977890,"name":"Jaclyn Pruitt","orcid":null,"position":2,"is_corresponding":false},{"id":65914,"name":"Chris Ward","orcid":"0000-0002-6954-9611","position":3,"is_corresponding":false},{"id":977545,"name":"Dyson T. Wake","orcid":"0000-0001-7112-026X","position":4,"is_corresponding":false},{"id":506234,"name":"Robert D. Gibbons","orcid":"0000-0002-6463-2280","position":5,"is_corresponding":false},{"id":307481,"name":"David O. Meltzer","orcid":"0000-0003-2790-7393","position":6,"is_corresponding":false},{"id":51075,"name":"Peter H. O’Donnell","orcid":"0000-0003-2650-0049","position":7,"is_corresponding":false},{"id":977546,"name":"Wanda Cruz-Knight","orcid":"0009-0005-1314-5289","position":8,"is_corresponding":false},{"id":312454,"name":"Peter J. Hulick","orcid":"0000-0001-8397-4078","position":9,"is_corresponding":false},{"id":525179,"name":"Henry M. Dunnenberger","orcid":"0000-0002-6211-1713","position":10,"is_corresponding":false},{"id":677873,"name":"Sean P. David","orcid":"0000-0002-4922-2603","position":11,"is_corresponding":false},{"id":677059,"name":"Loren Saulsberry","orcid":"0000-0003-0325-2329","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":null,"created_at":"2026-07-19T00:30:50.076284Z","pmid":"35887642","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}