Cultural Diversity
Cultural and Genetic Diversity in America: The Need for Individualized Pharmaceutical Treatment, by Valentine J. Burroughs, et al., 2002
Pharmacogenetic research in the past few decades has uncovered significant differences among population groups in the metabolism, clinical effectiveness, and side effect profiles of many clinically important drugs. In addition, differences in how various populations view and respond to medicines underscores the need for an individualized approach to pharmaceutical therapy. Cost management policy design must take these differences into
account in order to ensure that they are broad and flexible enough to enable rational choices and individualized treatment for all patients, regardless of racial or ethnic origin. Fact Sheet available.
Annotated PowerPoint slides related to this report are available.
Ethnic Disparities in the Burden and Treatment of Asthma, 2005
In the United States the burden of asthma falls disproportionately on the black and Hispanic—largely Puerto Rican—populations, especially children. Much of this disparity has been attributed to unequal access to preventive care. Black and Puerto Rican children characteristically under-use routine health care services and overuse emergency care services for asthma. This report, developed in partnership with the Asthma and Allergy Foundation of America, discusses: disparities in the burden of asthma; possible hereditary, environmental, and behavioral causes of these disparities; and ways in which these asthma disparities may be lessened.
Annotated PowerPoint slides related to this report are available.
Genes, Culture, and Medicines: Bridging Gaps in Treatment for Hispanic Americans, by Carolina Reyes, MD, et al., 2004
This report brings together for the first time a growing body of scientific research demonstrating substantial disparities in pharmaceutical therapy for Hispanic Americans. These disparities in pharmaceutical treatment are substantial and often persist even after adjustment for differences in income, age, insurance coverage, and coexisting medical conditions. Emerging research demonstrates that genetic variations affect Hispanic Americans and may require dosage adjustments to achieve an optimal therapeutic effect.
Fact Sheet available.
Annotated PowerPoint slides related to this report are available.
Genetic Variations in Response to Medications: Looking at the Implications for Minority Elders, by Richard Levy and Jean Polatsek, Healthcare and Aging, Vol. 9, No. 1, Spring 2002
Genetic, environmental and cultural factors influence variations in drug response among elders from different racial and ethnic backgrounds. Racial and ethnic heritage can be an indicator of special medical needs and differing drug responses; if ignored these differences in treatment response, can lead to compromised care and greater health risks. In addition, substantial dosing
adjustments may be necessary to avoid overdosing or underdosing. Reprinted with permission from Healthcare and Aging, Vol. 9, No. 1, Spring 2002. Copyright © 2002 American Society on Aging San Francisco, California. Also published in Diversity Currents, Vol. 4, No. 2, Spring 2002.)
The Importance of Individualizing Prescribing among Genetically and Culturally Diverse Groups, by Valentine J. Burroughs, MD, Group Practice Journal, Vol. 52, No. 3, March 2003
Addressing individual patient needs can provide better overall utilization of health care resources and improve health outcomes. Because patients differ in how their bodies process drugs due to many factors—age, gender, genetic variations, etc.— patients may experience different levels of effectiveness from drug therapies and variations in side effects associated with a particular drug. Thus individualized prescribing is key to making sure that each patient receives the right drug, in the right dose, and at the right time.
Racial and Ethnic Differences in Response to Medicines: Towards Individualized Pharmaceutical Treatment, by Valentine J. Burroughs, Randall W. Maxey, and Richard A. Levy, Journal of the National Medical Association, Vol. 94, No. 10 (Suppl.), October 2002
It is now well documented that substantial disparities exist in the quality and
quantity of medical care received by minority Americans, especially those of African, Asian, and Hispanic heritage. In addition, the special needs and responses to pharmaceutical treatment of these groups have been undervalued or ignored. This article reviews the genetic factors that underlie varying responses to medicines observed among different ethnic and racial groups.
Annotated PowerPoint slides related to this report are available.
CME credit is available through the National Medical Association.
Toward Individualized Pharmaceutical Care of East Asians, by Alan Morrison, PhD, and Richard A. Levy, PhD, Pharmacogenomics, Vol. 5,
No. 6, September 2004
Research into the relationship between genetics and drug response has focused on variations in genes that encode drug-metabolizing enzymes. Much of this work has targeted East Asians, a genetically distinguishable and populous group. Variations known to inactivate a drug-metabolizing enzyme are predictive of poor metabolism of drugs processed by that pathway. Genetic tests can be used to screen for individuals who are poor metabolizers, with the ultimate goal of better predicting the clinical effects of drugs. A non-technical summary of this paper is available.
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