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Avera tests genetics for pain meds with pioneer treatment method

Avera Medical Group is pioneering a genetics-based approach to offer more personalized treatment for patients recovering from surgery.

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Avera officials announced Wednesday that patients treated by orthopedic surgeons at two Avera facilities — Orthopedics and Sports Medicine in Mitchell and CORE Orthopedics in Sioux Falls — can have their blood drawn and tested to determine which pain medications will be most effective following surgery.

According to Krista Bohlen, a research pharmacist with Avera’s Institute for Human Genetics in Sioux Falls, this type of testing has never been offered in South Dakota and is uncommon nationwide.

She spoke to The Daily Republic on Wednesday along with other Avera officials, including Avera Queen of Peace Regional President and CEO Tom Clark.

“This is leading-edge technology,” Clark said. “And you can get it right here in Mitchell.”

Brian Kampmann, an orthopedic surgeon with Avera’s Orthopedics and Sports Medicine in Mitchell, said without this test- ing, physicians have had to rely on trial and error to find out which drug is most effective in treating each patient’s pain following surgery.

“This way, we have all that information ahead of time,” he said.

Patients who could benefit from the testing will be asked a series of questions about their history with pain medications to determine if the testing is medically necessary, Bohlen said.

Once a blood sample is taken, it will be shipped to Avera’s Institute for Human Genetics in Sioux Falls for testing. It takes approximately 72 hours to complete the testing at the lab.

The testing examines how certain pain medications are processed, or metabolized, in the liver. Once the testing is complete, physicians will receive a one-page report, which will include specific information to help them choose which pain medication is best suited to a patient. After six years of research, Bohlen and others at Avera’s genetics lab have spent the last few months preparing to make the testing operational, Bohlen said. “We’re moving it from bench to bedside,” she said. At first, the testing will only be offered to Avera’s orthopedic patients, Clark said, but if it’s successful, it could be expanded into other areas as soon as one year from now.

“More people will expect this,” Bohlen said. “They’ll see the value in it and that will just drive the need.”

Initially, Avera’s genetics lab will be able to handle about 50 to 100 tests per week, but that is expected to increase as more automation is worked into the process in the future, Bohlen said.

The cost of the testing, which is between $2,000 and $2,500, will be covered by Medicare and some, but not all, other insurance providers, Clark said.

As a Catholic organization, Avera is conscious of the ethical questions that can sometimes accompany genetic testing, Clark said.

“Down the road, there certainly could be ethical issues that come up and need to be discussed,” he said.

With the limited scope of this testing — which is basically a “chemical snapshot” of a patient’s liver, according to Bohlen — those questions don’t really apply in this case, Clark said.

For now, the testing is simply a tool to help physicians treat patients’ pain after surgery, Kampmann said.

“I assume in the future we’re going to find more uses for other parts of our genetic code,” he said. “I imagine it will just get bigger and bigger.”