Pharmacogenetic, drug-gene interaction, clinical, and sociodemographic determinants of frequent use of the healthcare system and its economic impact

Pharmacogenetic, drug-gene interaction, clinical, and sociodemographic determinants of frequent use of the healthcare system and its economic impact | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL British Journal of Clinical Pharmacology This is a preprint and has not been peer reviewed. Data may be preliminary. 12 May 2026 V1 Latest version Share on Pharmacogenetic, drug-gene interaction, clinical, and sociodemographic determinants of frequent use of the healthcare system and its economic impact Authors : Patricia Ojalvo-Guiberteau [email protected] , Levin Thomas [email protected] , Carmen Mata-Martín [email protected] , Juan-Antonio Villatoro-García [email protected] , Carla González de la Cruz [email protected] , Jesús Cobaleda [email protected] , Agustín Pijierro [email protected] , Eva Peñas-LLedó [email protected] , and Adrian LLerena 0000-0002-5663-7081 [email protected] Authors Info & Affiliations https://doi.org/10.22541/authorea.15003194/v1 33 views 13 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Aim: To identify demographic, clinical, pharmacogenetic, and drug-gene interaction determinants of frequent healthcare utilization across multiple care settings in a genotyped Spanish population, and evaluate healthcare costs across clinical, drug treatment, and pharmacogenetic strata. Methods: This retrospective study included 804 patients attending a primary healthcare center in Badajoz, Spain. Participants were genotyped for CYP2D6, CYP2C19, and CYP2C9. Frequent use was defined as healthcare utilization ≥90 th percentile over the preceding five years across five settings: global healthcare system, primary care, outpatient medical specialties, emergency department, and hospitalizations. Determinants of frequent use were evaluated using bivariate analyses and multivariable logistic regression. Healthcare utilization costs were estimated using public tariffs issued by Extremadura Healthcare Service. Results: Frequent users accounted for a disproportionate share of healthcare visits (27.6–69.4%). Hyperpolypharmacy was associated with the highest odds of frequent utilization across all settings (adjusted odds ratios: 5.50-16.55). Chronic disease was associated with frequent global and outpatient medical specialty utilization. Strong CYP2D6 inhibitor prescribing was associated with frequent emergency department and outpatient medical specialty utilization. CYP2C19 gene–substrate interactions were significant in bivariate analyses but not in multivariable models. Among frequent users, non-normal CYP phenotypes were associated with higher mean healthcare costs across most gene–substrate drug interactions, supporting pharmacogenetic-guided prescribing as a cost-reduction strategy. Conclusion: Hyperpolypharmacy was consistently associated with higher odds of frequent healthcare utilization, with setting-specific associations observed for other variables. Pharmacogenetic influence on frequent healthcare utilization may become clinically relevant in the context of substrate drug exposure and warrant validation in larger cohorts. Supplementary Material File (supplementary_file_s1.docx) supplementary_file_s1 Download 86.16 KB Information & Authors Information Version history V1 Version 1 12 May 2026 Collection British Journal of Clinical Pharmacology Authors Affiliations Patricia Ojalvo-Guiberteau [email protected] View all articles by this author Levin Thomas [email protected] View all articles by this author Carmen Mata-Martín [email protected] View all articles by this author Juan-Antonio Villatoro-García [email protected] View all articles by this author Carla González de la Cruz [email protected] View all articles by this author Jesús Cobaleda [email protected] View all articles by this author Agustín Pijierro [email protected] View all articles by this author Eva Peñas-LLedó [email protected] View all articles by this author Adrian LLerena 0000-0002-5663-7081 [email protected] View all articles by this author Metrics & Citations Metrics Article Usage 33 views 13 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Patricia Ojalvo-Guiberteau, Levin Thomas, Carmen Mata-Martín, et al. Pharmacogenetic, drug-gene interaction, clinical, and sociodemographic determinants of frequent use of the healthcare system and its economic impact. Authorea . 12 May 2026. DOI: https://doi.org/10.22541/authorea.15003194/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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