A GP Practice in Cambridgeshire is the first in our region to take part in a national project which is looking to establish the feasibility of providing an NHS-wide diagnostic service to identify genetic changes associated with commonly prescribed drugs.
The Pharmacogenetics Roll Out – Gauging Response to Service study, or PROGRESS for short, is using pharmacogenomics to examine how an individual's genetic makeup influences their response to medications.
Dr Malav Bhimpuria, Lead GP at the Alconbury and Brampton Surgeries in Cambridgeshire, began recruiting patients to the project after contacting Professor Bill Newman, who is leading this national project on behalf of the NHSE Network of Excellence in Pharmacogenomics and Medicines Optimisation.
Dr Malav says: “So far we have recruited 90 patients. The process is very simple. We provide a saliva kit for the patient to provide a sample at home, which is then sent off for pharmacogenomic testing.
Half of our patients have had their prescriptions altered thanks to a more precise genetic understanding of how they respond to their medications. We have been able to reduce people’s dosage and even start patients on a new, more appropriate medication
Dr Malav Bhimpuria, Lead GP at the Alconbury and Brampton Surgeries in Cambridgeshire
This is particularly important with selective serotonin reuptake inhibitors (SSRIs) prescribed to patients with depression or anxiety. When prescribing SSRIs, the process is often a "trial-and-error" sequence because there is no way to know in advance which medication will be most effective for an individual.
Reducing 'trial and error'
“For many patients, it can take months of trying different drugs and dosages to find an effective treatment with manageable side effects” says Dr Malav. “Pharmacogenomic testing analyzes a patient's DNA to identify variations in genes that influence how they process and respond to medication. This allows us, as clinicians, to make more informed decisions by providing insights to tailor treatments to the individual, providing truly personalised medicines”.
Randomized controlled trials have compared pharmacogenomics-guided treatment to standard care for depression, with positive results including higher remission and response rates, fewer side effects, improved adherence and reduced medication switching.
Dr Malav has also found benefits for patients with high cholesterol. “In the case of statins, which are typically prescribed to manage high cholesterol, many patients decline these due to their possible side-effects. But through pharmacogonemomic testing we can understand the likelihood of side effects for a particular patient, which has made statins more acceptable to these patients.
"A key challenge for the NHS is to go from a model of treatment to one of prevention. The personalised insights generated by pharmacogenomic testing are key to this, as they allow us to make personalised and tailored treatment decisions for patients”.
Benefits to GP Practices
As well as benefitting patients, involvement in the PROGRESS study has also helped Dr Malav and his colleagues. “There is no cost to us as a practice, with very little extra work above minor form filling. In the long run, we recognise that using a genetic basis to understand people’s reactions to medications could actually reduce our workload, by reducing the standard “trial and error” in prescribing, which in turn should result in fewer consultations and hospital admissions due to adverse drug reactions”.
I was delighted to be asked to take part. It was so easy to participate. The potential for bespoke medication targeted very precisely at individual patients not only increases the effectiveness of the intervention, but also must surely lead to less stress for patients with the reduction in 'trial and error' prescribing and of course to savings for the NHS. It clearly has great potential for both patients and medical practitioners.
Patient at Alconbury Alconbury and Brampton Surgeries in Cambridgeshire, who has taken part in the PROGRESS study
Bill Newman, Professor of Translational Genomic Medicine at the University of Manchester said: “The national rollout of PROGRESS signifies a significant step towards embedding genomics into routine NHS healthcare, advancing precision medicine, and improving medication safety and effectiveness.
We look forward to sharing outcomes from the research study next year and hope that this work will have a major benefit on patient care across England
Bill Newman, Professor of Translational Genomic Medicine at the University of Manchester
The PROGRESS study will continue to recruit patients at GP practices across England until December 2025.
Find out more about the PROGRESS project here. (opens in a new tab)