You have your Sanford Chip genetic test results. Now what?

A genetic counselor details how you and providers can use the information.

By: Sanford Health News .

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Whether it’s to get answers to lingering questions or fears, or to help guide care moving forward, or simply to learn more about their health, thousands of Sanford Health patients have taken the Sanford Chip genetic test.

They’ve had their basic questions answered, know the conditions and medications the test covers, enrolled for the test, understand how the test works and are now ready for the next step — getting the results of their test.

Here, genetic counselor Erin Royer addresses some questions patients may have about the results of the Sanford Chip.

How will I get my Sanford Chip results?

You’ll receive a message in My Sanford Chart under “Test Results,” listed by the date your blood was drawn. One message will include your basic pharmacogenetic panel results, and one will include your disease predisposition results.

You can access your results at any time through My Sanford Chart. They also will be part of your electronic medical record for your providers to review and consult.

Additionally, you’ll receive a letter in the mail from Sanford Imagenetics with a report that gives more explanation and detail about your results.

What does the mailed report say about my results?

The report has three sections of information about your pharmacogenetic test results:

  • A table of potentially affected medications, based on your genetic results
  • Drug dosing recommendations, based on your genetic results
  • Test details and methodology

Potentially impacted medications

The categories in this table work like a stoplight.

Medications listed in the green section are good to go — you can use those at the standard dosing, because your genetics aren’t giving any indication you would have any different reactions than the general public with those medications.

Medications listed in the yellow section are ones to maybe use with caution. For these, your provider might consider a different dose, or consider closely monitoring for things like side effects or whether the medication is working well.

And medications listed in the red section, it’s not quite a “stop,” but it’s “maybe we should think about other medications.” Maybe this medication will cause a side effect that’s not good, or maybe it won’t work for you as well as other people, so other medications might work better for you.

Drug dosing recommendations

This section of your Sanford Chip results letter lists specific drugs that go through one of the genes the Sanford Chip tests. Here, it lays out how you metabolize — or break down and process — the specific medications and offers recommendations of the doses of the medication you may need, depending on whether you have a normal sensitivity to it, or whether you’re more sensitive or less sensitive than other people.

Test details and methodology

This part of the letter lists more specific breakdowns of the genes that were tested, as well as additional information about how these results were created from your DNA.

Under the test details, you’ll see four columns: gene, genotype, phenotype and alleles tested. These details are also listed in the results you access through My Sanford Chart.

The gene column lists the scientific name of the gene that was tested.

Next to that, the genotype tells us how that gene is spelled — it’s what makes up that gene.

The phenotype listed tells how you process the enzyme the gene makes.

And the alleles listed are simply the names used for the different changes that can be found in that gene — it’s all the variations tested for in that gene.

This level of information might not always be as helpful to you, the patient, but it’s very helpful to doctors and pharmacists when they’re reviewing or prescribing your medications.

We use all of this information when looking at a particular medication — we look at whether the enzyme breaks it down quickly or slowly, and based on that medication, how being broken down too quickly affects it versus too slowly. It’s not the same for every medication, so it’s great to have the additional support and review from our pharmacists.

Do I need to bring the results letter to my medical appointments?

No, the letter is just for your reference as a way to help interpret this complicated information. All the information from your Sanford Chip test is stored electronically in your medical record. It’s listed with your lab test results, just like a cholesterol level or blood sugar or blood panel that your doctor may have ordered in the past.

What does an ‘uninformative’ result mean for the disease predisposition portion of the Sanford Chip?

An “uninformative” result is what most people will get for this portion of the test.

We test 59 different genes that have medically actionable predispositions, where we look for common changes in those genes that we know greatly increase the risk of certain conditions or cancers. If that gene has a change, there’s some medical action we can take to help you with that particular risk or condition. We can start screenings or modify medications, for example.

If your results show you have a positive disease predisposition, you’ll be referred to a genetics specialist for next steps.

If your results show you don’t have any of these common changes in these 59 genes, it’s called uninformative.

Uninformative says you’re negative for all the predispositions we tested for, which is helpful to rule out some for the genetic causes of those issues.

But this doesn’t change your family history, which is also a factor in your risk of developing certain conditions. An uninformative result for these specific genes doesn’t mean you’ll never get cancer or have a heart attack or have high cholesterol.

So if you’re worried about anything in your family history, you can always meet with a genetic counselor or provider who specializes in cancer or cardiovascular disease to talk through your family history and see if any other testing might be useful, or any other screening should be started to monitor your risk.

What does my doctor do with the Sanford Chip results?

Your results are built into the decision support in all your medical reports. This means the next time your doctor wants to prescribe a medication, if something in your genes tells us you may not react well to that medication, or it may not work well, an alert will pop up to tell your doctor that that medication might not be best for you. It will suggest whether a lower dose or higher dose would work better, or other medications that might be better for you to try.

We also have pharmacists who review your results and your current medications to see if anything you’re using right now as a medication might not work that well or might need to be adjusted based on your genetics. Our pharmacists will communicate back to your doctor right away about any potential issues with your current medications.

That’s something unique to Sanford Health’s testing; since the lab results are entered directly into your chart, any Sanford Health provider you see in any specialty has access to them as they treat you.

What do I do now?

This is different for everyone who takes the Sanford Chip test, depending on what your results are.

If medication changes need to be made, or actions need to be taken to help treat or prevent a condition, our team will contact you and be with you every step of the way to make sure you’re getting the care you need.

For people with no complications from medications, or with uninformative predisposition results, it likely means you don’t have to do anything differently. It rules out some genetic causes of certain conditions, and it equips your provider with helpful knowledge regarding medications you may need in the future.

Two patients’ perspectives about their Sanford Chip results

Feeling more in control

Ashley Schwab and Megan Baldridge recently received their Sanford Chip results and had a common reaction: relief.

“I took the Sanford Chip test because I worry about everything,” Baldridge says. “As a woman, something like the possibility of having BRCA1 or BRCA2 was always a concern in the back of my mind. So having these results that show I don’t have these specific genetic changes, and I can follow normal screening protocols and normal lifestyle choices, that was a huge sigh of relief to me.”

“It can be scary if you find out that you have a condition, and how do you handle that. But not knowing is also scary,” Schwab said. “If your risk is there, it’s still going to be there whether you know about it or not. So by knowing that and being able to figure out what to do about it, I feel much more comfortable knowing that I’m doing what I can to prevent it. It’s not a guarantee, but I’m trying.”

Baldridge agreed that knowing the information from her Sanford Chip results helps her feel more in control.

“When I was talking to friends and family about the test, they were like, ‘Oh, I wouldn’t want to know if I have that kind of thing.’ But for me, it’s like the more information I have, the more reassured I can be, or the more proactive I can be,” she said. “It feels like a sense of empowerment, a ‘knowledge is power’ kind of thing.”

Answering questions

For Schwab, her results filled in some gaps in information about her health.

“I can control what I do in a day, what I eat, how much I exercise, how I’m going about screening, those types of things,” she explained. “But the one thing I didn’t know is what did I inherit? I was able to take the information from my results and put all the puzzle pieces together to figure out what lifestyle things I can do, what screenings I should do, what is part of my family history, what is genetics. I can put it all together to figure out how do I best live my life to be proactively preventing things.”

Baldridge said talking to people about the Sanford Chip also has helped dispel some misconceptions.

“I’ve had a couple people ask me if the chip feels weird,” she said with a laugh. “It’s nice to be able to explain that it’s just a blood test. My family is also really into genealogy and doing those kinds of ancestry tests. It’s been interesting to explain how this kind of test is different, how it’s really about your health and medications. And that your doctors can do something with your results.”

Getting insights and reassurance

The simplicity of what the patient needs to do to have the test done, paired with the many ways the results can be used in health care decisions, makes both Schwab and Baldridge glad they did it.

“For me, I wanted to know before I needed something,” Schwab said. In addition to knowing she doesn’t carry any of the genetic disease predispositions, seeing how she processes medications was helpful, too.

“I’ve had friends and family members who have had negative side effects for medications, and I didn’t want to experience that,” she said. “I know my doctor looked at my medications and my results to see if there are any things I needed to shift because of that. And there wasn’t any. It has given me peace of mind, having the ability for them to confirm that the medications I have are working and are the best option for me.”

Baldridge said the medication results are especially valuable to her. “I’ve had a lot of really bad side effects to a lot of different medications. So getting the results to show I really do process some of these kind of drugs differently, it reassured me that it’s not something wrong with me, it’s my genetics. For something like depression or anxiety, you don’t want that to get any worse because of a medication. So having this information is really powerful. It’s something that going forward, my doctor could know from the start, ‘Maybe this drug would be better than that one,’ instead of always doing a trial and error.”

Immediate benefits

Schwab points out the potential of the Sanford Chip to help people with all kinds of conditions.

“If someone has cardiac problems or heart disease, it’s so important to have the right medication working effectively,” she said. The same goes for people getting treated for infections, immune system issues or high cholesterol. Even treating things that aren’t immediately life-threatening can be greatly affected by the medications used.

“Some people will stop taking a medication because of the side effects. They’d rather deal with their pain or depression symptoms than deal with the side effects of a medication,” Schwab said. For others, they might stop taking a medication because they don’t see any improvement at all. “So being able to find out before you take a medication, knowing if this medication will work as well for you. Or you need a different dosage. Or you need a different medication. I think that is so empowering for people that are dealing with some of these things that really affect their day-to-day lives.”

Learn more about the Sanford Chip genetic test.

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