The NHS are transitioning from no clopidogrel test to23 Aug 2024 09:05
NICE recommends it happens to people who have had a stroke, right?
What the document says:-
1 Recommendations
1.1 Use CYP2C19 genotype testing to assess if clopidogrel is a suitable antiplatelet drug for people who have just had an ischaemic stroke or a transient ischaemic attack (TIA). CYP2C19 genotype testing is only recommended if:
quality-assurance processes and arrangements are in place for point-of-care tests
shared decision making for doing the test is established (see NICE guidance on shared decision making).
When interpreting test results, healthcare professionals should take into account that the prevalence of different CYP2C19 genotypes may vary between ethnic groups.
Laboratory-based testing
1.2 Use laboratory-based testing for CYP2C19 genotype testing.
***Point-of-care testing***
1.3 Use the Genedrive CYP2C19 ID Kit point-of-care test for CYP2C19 genotype testing when laboratory-based testing is not available.
1.4 Use the Genomadix Cube point-of-care test when laboratory-based testing and the Genedrive CYP2C19 ID Kit point-of-care test are not available.
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As I understand it previously, they did not do the test at all.
Obviously for ***Point-of-care testing*** the hospitals will need a Genedrive machine “when laboratory-based testing is not available.". This is a bit ambiguous. I should think the bigger hospitals may have their own in house lab? So maybe this comment is made for the ones that don't? In any event it clearly says, "Use the Genedrive CYP2C19 ID Kit point-of-care test for CYP2C19 genotype testing when laboratory-based testing is not available.", and you can't do that if you do not have at least one available to use, right?
Bottom line is it's faster than a lab test by hours if not days, does not need a blood draw and if cheaper. Once they get used to using it, they will prefer to use it IMHO.
https://www.nice.org.uk/guidance/dg59/chapter/1-Recommendations
All IMHO.