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February 2020 saw the publication of a new clinical practice guideline for non-steroidal anti-inflammatory drugs (N

February 2020 saw the publication of a new clinical practice guideline for non-steroidal anti-inflammatory drugs (NSAIDs) in patients with decreased activity of CYP2C9. This guideline provides dose recommendations for NSAIDs that might help to prevent adverse drug reactions. 


You are a clinical pharmacist supporting patient medication management in a large orthopedic surgery practice at a large academic medical center. Your day-to-day generally involves managing patients taking long-term NSAID medications and trying to ensure that risk for ADEs is properly managed.

At a monthly meeting of all clinicians, you propose that your practice perform  CYP2C9 testing for all patients treated with NSAIDs. Your colleagues are completely on board with your proposal and agree to help secure funding to support a clinical trial of the effectiveness of the test at reducing ADEs. They request that you formulate a research proposal to evaluate the degree to which the test results alter prescribing decisions. They have also requested that you compare patients receiving genetic testing with a historical control to determine changes in adverse drug reactions from NSAIDs. 


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