How Pharmacogenomics Helped Save a Patient From Polypharmacy Harm

In a healthcare landscape where one-size-fits-all prescribing often falls short, pharmacogenomics (PGx) is emerging as a powerful, personalized solution—especially for older adults burdened by complex medication regimens. At GeriatRx, we’ve seen firsthand how this innovative approach can reduce polypharmacy, improve clinical outcomes, and even save lives.

This case study highlights how a PGx intervention helped uncover the hidden reason behind one patient’s worsening symptoms—and why embracing personalized medication management is critical in geriatric care.

The Patient: A 66-Year-Old Woman in Decline

A 66-year-old woman presented to us with a complex medication profile and an equally complex set of symptoms: worsening cognition, balance issues, and multiple hospitalizations within the last six months. Her family described her as “not herself”—forgetful, fatigued, and increasingly withdrawn.

She was taking over 15 medications, including several psychotropics. Despite escalating care, nothing seemed to work. That’s when her care team turned to GeriatRx for a comprehensive medication review and pharmacogenomics consultation.

Step One: A Comprehensive Medication Audit

We began by conducting a thorough deprescribing assessment—reviewing her prescription medications, over-the-counter drugs, and supplements. Our team identified several red flags, including:

• A combination of medications that increased fall risk and sedation

• High-risk anticholinergic drugs contraindicated in older adults

• A concerning number of duplicative prescriptions

  
  

But even after this review, some questions remained. Why was she reacting so poorly to medications that were considered “standard” in her treatment plan?

Step Two: Pharmacogenomic Testing

That’s where PGx came in.

We ordered a simple buccal swab to analyze her genetic makeup—specifically, how her body processes certain drugs. The results revealed significant CYP2D6 and CYP2C19 enzyme abnormalities, meaning her body could not properly metabolize several commonly prescribed medications.

This explained why medications that should have helped her were, in fact, causing harm. She was essentially being overdosed by drugs her body couldn’t process—leading to toxic buildup, cognitive side effects, and heightened fall risk.

Results: Fewer Medications, Better Outcomes

Armed with PGx results and a deprescribing roadmap, we worked with her provider to make evidence-based changes:

• Five medications were safely tapered and discontinued

• Two were replaced with alternatives better suited to her genetic profile

• Non-drug interventions were added to manage mood and sleep

  
  

Within three months, the results were clear:

• The patient was more alert and communicative

• Her gait improved, and she experienced no further falls

• Emergency room visits dropped to zero

• Her medication list was reduced by 33%

  
  

Most importantly, her family felt like they had her back.

Why PGx Matters in Older Adult Care

Polypharmacy and medication-related harm are not rare in older adults. In fact:

• Up to 40% of older adults take five or more medications

• Adverse drug reactions are responsible for over 100,000 deaths annually in the U.S.

• Many medications are metabolized differently based on a person’s genes—but genetic differences are rarely tested for in standard care

  
  

Pharmacogenomics addresses this gap by offering precision prescribing. Rather than guessing which medication might work, PGx allows clinicians to:

• Avoid ineffective or harmful drugs based on enzyme activity

• Select safer alternatives

• Reduce time to therapeutic effect

• Prevent hospitalizations due to adverse drug events

  
  

What This Means for Health Plans and Providers

For organizations like SCAN Health and other value-based care providers, PGx represents a high-impact opportunity to improve outcomes and reduce costs.

• Reduced hospitalization rates: Fewer adverse drug reactions mean fewer ER visits and admissions.

• Improved HEDIS & STAR metrics: Better medication reconciliation and fall prevention translate directly to quality performance.

• Lower pharmacy costs: By deprescribing unnecessary or ineffective medications, plans can optimize formularies.

• Better patient engagement: Personalized medicine increases trust and adherence.

  
  

As more health systems shift toward whole-person, preventive models of care, PGx is no longer a “nice to have”—it’s a necessary tool in optimizing medication safety for vulnerable populations.

GeriatRx’s Role in the PGx Movement

At GeriatRx, we don’t just perform PGx testing—we help build deprescribing systems that incorporate it effectively. Our approach includes:

• Staff training on interpreting and applying PGx results

• Deprescribing protocols that integrate clinical, social, and genetic data

• Consultative support for providers, pharmacists, and care teams

• Community engagement to educate families and caregivers

  
  

Whether piloting PGx with one high-risk population or scaling across a health plan, we guide partners through the clinical, operational, and compliance steps needed for success.

Conclusion: The Future of Safer Prescribing is Personal

This case underscores a simple but powerful truth: medication safety isn’t about prescribing more—it’s about prescribing smarter. For older adults, who are often on complex regimens, pharmacogenomics can mean the difference between deterioration and recovery.

At GeriatRx, we believe the future of geriatric care is personalized, data-informed, and patient-centered. And we’re proud to lead the charge.

If you’re ready to explore how pharmacogenomics and deprescribing can transform care for your patients, visit GeriatRx.org to learn more.