University of Southampton researchers awarded £3M to make medicines safer for older people using genomics
Researchers at the University of Southampton have secured around £3 million from the National Institute for Health and Care Research (NIHR) to investigate whether genomic testing could help make prescribing medicines safer and more personalised for older people.
The PRIMO programme (Pharmacogenomics Research for Individualised Medicine in Older People) will explore how genetic information could be used as part of routine medication reviews. The aim is to help doctors and pharmacists identify the safest and most effective medicines for individual patients.
Led by Dr Kinda Ibrahim and Professor Diana Baralle , the programme will focus on older adults experiencing polypharmacy, commonly defined as taking five or more regular medicines.
A growing challenge for older people
As people get older, many develop multiple long-term health conditions that require treatment with several medicines. While these medicines are often necessary, taking multiple drugs can increase the risk of adverse drug interactions.
Polypharmacy affects around one-third of adults aged 65 and over. Adverse drug reactions account for a significant proportion of hospital admissions and are estimated to cost the NHS around £2 billion each year. Older people and those living in more deprived communities are particularly affected.
Structured Medication Reviews are now a key part of NHS policy, helping patients and healthcare professionals regularly review prescribed medicines. However, these reviews do not routinely take account of genetic differences that can affect how people respond to medicines.
One potential way to address these challenges is through pharmacogenomics, which uses genetic information to help guide prescribing decisions and tailor treatments to individual patients.
Using genetics to personalise prescribing
Pharmacogenomics examines how genetic differences can affect a person’s response to medicines. More than 90 per cent of people carry at least one genetic variant that could influence prescribing decisions for certain drugs.
Research has shown that using genetic information to guide prescribing decisions can reduce medication-related harm and improve treatment outcomes. However, there is currently limited evidence on how this approach could work in UK primary care, particularly for older adults taking multiple medicines.
Dr Kinda Ibrahim said: “ This funding is both timely and transformative. By bringing together leading experts in pharmacogenomics and medicines optimisation, alongside NHS partners, patients and public contributors, we will tackle the major challenge of medicine-related harm in people taking multiple medicines.”
“PRIMO will generate the evidence, tools and implementation strategies needed to support the NHS 10-Year Health Plan and embed pharmacogenomics into routine practice, enabling safer, more effective and truly personalised prescribing based on a person’s genetic profile, clinical needs and preferences.”
The programme brings together researchers, NHS partners, pharmacists, genomics specialists, health economists, public contributors and primary care teams from the University of Southampton , the University of Oxford , Aston University , the NHS, the Health Innovation Network and Queen Mary Clinical Trials Unit .
The interdisciplinary team was brought together through Wessex Health Partners , which also supported the development of the research programme through a series of workshops that helped shape the proposal and research agenda.
Testing genomics in primary care
Researchers will develop and validate a genetic test that could help healthcare professionals understand how individual patients are likely to respond to different medicines.
The team will work with NHS laboratories to ensure the test can be used easily within existing NHS systems, allowing results to be shared easily with GPs and pharmacists. If successful, this could make it easier to adopt the approach more widely across the NHS.
The research will begin with a small study involving 34 patients across four GP practices before expanding into a larger trial involving more than 1,000 people aged 65 and over who take five or more regular medicines.
The study, which will involve 30 GP practices in Birmingham and the South West, will compare standard medication reviews with reviews informed by patients’ genetic test results. Researchers will assess whether genetic information helps healthcare professionals make better prescribing decisions and reduces medicine-related harm.
The team will also examine the impact on side effects, medication burden, treatment adherence, quality of life, healthcare use and NHS costs. A dedicated Public Advisory Group will contribute throughout the programme, helping to shape the study and share results with local communities.
Professor Diana Baralle said: “ We are excited to begin work on this new NIHR-funded pharmacogenomics programme. It represents an important step towards bringing the benefits of genomic medicine into everyday healthcare.”
Supporting the NHS workforce
Alongside the research, PRIMO will support doctors, pharmacists and other primary care professionals to develop the knowledge and confidence needed to use pharmacogenomic information in everyday practice.
The programme will build on the nationally recognised Polypharmacy Action Learning Sets, developed and delivered through the Health Innovation Network, which have already trained more than 1,300 GPs and pharmacists across England.
New training resources will help healthcare professionals interpret pharmacogenomic test results, discuss them with patients and use them safely during medication reviews.
If successful, PRIMO could provide the evidence needed to support wider use of pharmacogenomic testing within NHS medication reviews. This could help reduce avoidable side effects, improve treatment outcomes and enable more personalised prescribing for older people across the NHS.