diff --git a/app/CONTRIBUTING.md b/app/CONTRIBUTING.md
index ec741343..971d42fc 100644
--- a/app/CONTRIBUTING.md
+++ b/app/CONTRIBUTING.md
@@ -129,6 +129,16 @@ _supported._
_Check `e60efb4f2fc3ba2efa7735ffb06ec5fdb64d7af6` for a rudimentary script_
_version, removed afterwards due to too many merge conflicts._
+## User Instructions
+
+Currently, the user instructions are a static HTML file that need to be updated
+manually if changes in the app content occur (at least the screenshots are
+linked and do not need to be updated after re-generation).
+
+We decided to host a PDF of the user instructions (for the study). To create
+this PDF, open the HTML file in a browser (tested with Chrome) and print with
+"Save to PDF".
+
## Adapting test data
If you would like to test with specific test data but you don't have a user with
diff --git a/docs/User-instructions.html b/docs/User-instructions.html
index b1b4c4ba..215ca6e8 100644
--- a/docs/User-instructions.html
+++ b/docs/User-instructions.html
@@ -1,3 +1,9 @@
+
+
PharMe: Getting Started & Further Resources
@@ -16,6 +22,20 @@
.no-pagebreak-inside {
break-inside: avoid;
}
+ .force-pagebreak {
+ page-break-inside: avoid;
+ page-break-after: always;
+ }
+ .reviewer-comment:before {
+ content: "Reviewer comment (will not be visible in the final PDF): ";
+ }
+ .reviewer-comment {
+ /* Uncomment for final print version */
+ /* display: none !important; */
+ }
+ body {
+ background-color: white;
+ }
}
body {
margin: 0;
@@ -30,8 +50,8 @@
margin-bottom: 0.4in;
}
h2 {
- margin-top: 0.3in;
- margin-bottom: 0.2in;
+ margin-top: 0.4in;
+ margin-bottom: 0.3in;
}
h3 {
margin-top: 0;
@@ -42,6 +62,17 @@
width: 8.5in;
background-color: white;
}
+.reviewer-comment:before {
+ content: "Reviewer comment (will not be visible in PDF): ";
+}
+.reviewer-comment {
+ color: orange;
+ font-style: italic;
+}
+.fake-link {
+ color: #221f73;
+ text-decoration: underline;
+}
.onboarding-page {
padding: 0.3in;
color: whitesmoke;
@@ -125,6 +156,14 @@
object-fit: contain;
filter: drop-shadow(lightgray 5px 5px 5px);
}
+.indicator-row {
+ display: flex;
+ flex-direction: row;
+ align-items: center;
+}
+.indicator-icon {
+ font-size: 1em;
+}
@@ -135,32 +174,29 @@ PharMe: Getting Started & Further Resources
In this document you find all information to get started with PharMe and further support while using it:
- - An app intro that explains what PharMe can do
- - An app tour, which leads through PharMe's main functions
- - Resources to learn about genetics
- - Our FAQ
+ - An app intro that explains what PharMe can do
+ - An app tour, which leads through PharMe's main functions
+ - Resources to learn about genetics
+ - Frequently asked questions (FAQ)
+These resources are also available in the app.
- If you have any questions or need assistance, please refer to the FAQ section or reach out via e-mail: ehivepgx@mssm.edu
-
-
We hope you will enjoy using PharMe and that you will learn useful
information about how your genes influence how well medications work for
you!
+
+ If you have any questions or need assistance, please refer to the FAQ section or reach out via e-mail: ehivepgx@mssm.edu
+
App Intro
Welcome to PharMe!
-
- Did you know? Your genes help decide how medications work in your body.
-
- In fact, 9 out of 10 people might react differently to medications than expected.
-
- PharMe helps you understand how your genes affect your medications.
-
+
Did you know? Your genes help decide how medications work in your body.
+
In fact, 9 out of 10 people might react differently to medications than expected.
+
PharMe helps you understand how your genes affect your medications.
@@ -181,11 +217,8 @@
Welcome to PharMe!
One Size Does Not Fit All
-
- Think of medications like shoes - one size doesn't fit all.
-
- A medication that works well for most people might not work the same way for you.
-
+
Think of medications like shoes – one size doesn't fit all.
+
A medication that works well for most people might not work the same way for you.
warning
@@ -207,8 +240,8 @@
One Size Does Not Fit All
Genome Power Unlocked to Improve Your Health
PharMe tells you if your genes might make certain medications work differently than expected, cause unwanted side effects, or not work well enough.
-
-
+
+
This field of medicine is called pharma-co-genomics (PGx).
@@ -232,10 +265,8 @@
Genome Power Unlocked to Improve Your Health
Tailored Just for You
PharMe works by looking at your gene information and checking it against what scientists know about genes and medications.
-
-
- We use information from trusted clinical PGx guidelines created by medical experts (CPIC and FDA).
+
We use information from trusted clinical PGx guidelines created by medical experts (CPIC and FDA).
@@ -243,10 +274,11 @@
Tailored Just for You
- PharMe only includes medications with clinical PGx guidelines from CPIC and the FDA.
-
-
- While only to a small percentage of medications have PGx guidelines, they are among the most commonly prescribed ones. If you cannot find a medication in PharMe, there may not be enough evidence for meaningful gene interactions.
+
PharMe only includes medications with clinical PGx guidelines from CPIC and the FDA.
+
+ While only to a small percentage of medications have PGx guidelines, they are among the most commonly prescribed ones.
+ If you cannot find a medication in PharMe, there may not be enough evidence for meaningful gene interactions.
+
@@ -261,11 +293,10 @@
Tailored Just for You
Keeping Your Information Safe
- We protect your privacy by storing your gene information and doing calculations only on your phone. We do not share your gene information with anyone.
-
-
- We also do not store any information that could tell someone who you are, such as your name.
+ We protect your privacy by storing your gene information and doing calculations only on your phone.
+ We do not share your gene information with anyone.
+
We also do not store any information that could tell someone who you are, such as your name.
![]()
Keeping Your Information Safe
+
+
App Tour
-
+
Get Started
- To get started with PharMe, you first need to agree to our
-
Terms of Use
- and
Privacy Policy.
+
+ To get started with PharMe, you first need to agree to our terms of use
+ and privacy policy.
+
+
You can review the documents here:
+
+ - Terms of use: https://pharme-services-sandbox.mssm.edu/terms
+ - Privacy policy: https://pharme-services-sandbox.mssm.edu/privacy
+
@@ -307,10 +346,10 @@
Login
+
App Intro
After successfully downloading your data, you will get an overview about
- what PharMe can do in the app intro (also see the
-
app intro above).
+ what PharMe can do in the app intro (also see the app intro above).
@@ -320,57 +359,77 @@
App Intro
Update Current Medications
- You can then review and update your current medications with PGx
- guidelines. Your current medications with PGx guidelines from your
- medical record will be pre-selected here.
-
-
- You will also be able to edit your current medications later in the
- app.
-
-
- Some medications can change how your body handles other medication.
- They can slow down or speed how your body processes medications.
-
-
- PharMe will warn you when this might happen.
+
+ You can then review and update your current medications with PGx
+ guidelines. Your current medications with PGx guidelines from your
+ medical record will be pre-selected here.
+
+
+ You will also be able to edit your current medications later in the
+ app.
+
+
+
+ If you are taking any of the following medications, please be sure to
+ add them. They can change how your body handles other medications.
+ PharMe will warn you when these medications interact with other
+ medications you are taking:
+
+
+ - Abiraterone (brand names: Yonsa, Zytiga)
+ - Bupropion (brand names: Aplenzin, Auvelity, Budeprion, Contrave, Forfivo, Wellbutrin, Zyban)
+ - Cinacalcet (brand names: Sensipar, Mimpara)
+ - Duloxetine (brand names: Cymbalta, Drizalma, Irenka, Yentreve)
+ - Fluoxetine (brand names: Act Fluoxetine, Prozac, Sarafem, Symbyax)
+ - Lorcaserin (brand names: Belvia)
+ - Mirabegron (brand names: Myrbetriq)
+ - Paroxetine (brand names: Paxil, Pexeva)
+ - Quinidine (brand names: Nuedexta)
+ - Terbinafine (brand names: Lamisil, Silka Cream)
+
-
+
-
+
Getting Around
- Great! You're almost ready to use PharMe. Let's show you how it works.
-
-
- At the bottom of your screen, you'll find four main buttons:
- "Medications", "Genes", "FAQ", and "More".
-
-
-
Want to see this tour again later? Just go to "More" and tap
- "Repeat app tour" or "Print app information".
-
-
+
Great! You're almost ready to use PharMe. Let's show you how it works.
+
+ At the bottom of your screen, you'll find four main buttons:
+ "Medications", "Genes", "FAQ", and "More".
+
+
+
Want to repeat this tour again in the app? Just go to "More" and tap
+ "Repeat app tour".
+
-
-
Finding Medications
- The "Medications" screen shows all medications in PharMe.
-
-
- You can search for medication names (both generic and brand names), look
- for types of medications, and filter the list by how well they work with
- your genes.
-
-
- Each medication has a color and symbol that shows how it might work for
- you based on your genes:
-
-
-
TODO: List of icons and descriptions
+
Finding Medications
+
The "Medications" screen shows all medications in PharMe.
+
+ You can search for medication names (both generic and brand names), look
+ for types of medications, and filter the list by how well they work with
+ your genes.
+
+
+ Each medication has a color and symbol that shows how it might work for
+ you based on your genes:
+
+
+ dangerous Consider alternatives
+
+
+ warning Use with caution
+
+
+ check_circle Standard precautions
+
+
+ help Standard precautions (incomplete data)
+
@@ -380,12 +439,14 @@
Finding Medications
Learning About Your Medications
- Tap any medication to see how well it might work for you, based on what
- science tells us about this medication and your genes.
-
-
- Here you can also mark medications you're taking and save information
- for your doctor.
+
+ Tap any medication to see how well it might work for you, based on what
+ science tells us about this medication and your genes.
+
+
+ Here you can also mark medications you're taking and save information
+ for your pharmacist or doctor.
+
@@ -395,15 +456,15 @@
Learning About Your Medications
Understanding Your Genes
- The "Genes" screen shows your gene test results that affect medications.
-
-
- Tap any gene to learn what your results mean and which medications it
- affects.
-
-
- Want to learn more? Check out the FAQ or go to "More" > "Learn about
- genetics."
+
The "Genes" screen shows your gene test results that affect medications.
+
+ Tap any gene to learn what your results mean and which medications it
+ affects.
+
+
+ Want to learn more? Check out the FAQ or go to "More" > "Learn about
+ genetics".
+
@@ -415,22 +476,213 @@ Understanding Your Genes
+
FAQ & Additional Features
-
Need help? Use "More" to get in touch with us or learn about the app,
- or check the FAQ for common questions.
-
-
- Under "More" you can also edit your current medication list.
+
Need help? Use "More" to get in touch with us or learn about the app,
+ or check the FAQ for common questions.
+
Under "More" you can also edit your current medication list.
Learn About Genetics
TODO: List from Aniwaa
-FAQ
+Frequently Asked Questions (FAQ)
+
+About Gene Testing and Medications (PGx)
+
-
+What is PGx?
+
+ PGx (short for pharma-co-genomics) explores how your genes affect how
+ medications work in your body.
+
+
+ Think of your genes like a recipe book that tells your body how to make
+ important proteins. These proteins help:
+
+
+ - Move medications through your body
+ - Break down medications to digest them to less active versions
+ - Activate medications my changing them to make them work in your body
+
+
+ Depending on the gene version you carry, these proteins may work faster or
+ slower than expected.
+
+
+ For example, if a protein that activates a medication
+ works slower than expected, it may not work properly for you because you do
+ not have enough working versions of the medication in your body. In such a
+ case, you might need a higher dose of the medication or might need to use a
+ different medication.
+
+
+Why is PGx important?
+
+ PGx helps pharmacists and doctors pick the right medications and doses for
+ you. It can help avoid bad reactions to medications before you even take
+ them.
+
+ But remember: Your genes are just one piece of the puzzle in how medications
+ work for you, other factors are also important, like your:
+
+ - Age
+ - Weight
+ - Other health conditions
+ - Other medications you are taking
+
+
+
+What can cause bad reactions to medications?
+
+ You might have a bad reaction to medication for several reasons:
+
+ -
+ Allergies: Sometimes your body thinks a medication is harmful and
+ fights against it. This can cause an upset stomach, itchy skin, or
+ in rare cases, very serious reactions.
+
+ -
+ Genes: Your genes affect how your body handles medications.
+
+ -
+ Unknown causes: Sometimes people have rare reactions that
+ pharmacists and doctors don't yet understand.
+
+
+ You can have more than one type of reaction at the same time. For example,
+ you might have both an allergy AND a reaction because of your genes.
+
+
+Does PharMe show all possible gene-related reactions?
+
+ No. Scientists are still finding new ways that genes affect medications. Different labs might also interpret gene tests differently as this is a new science.
+
+
+ PharMe uses trusted guidelines from medical experts (CPIC and FDA) to give you the most up-to-date information.
+
+
+What do my gene results mean?
+
+ Your results show two things:
+
+ - Your gene versions (called genotype): You have two copies for one gene, one from your mom and one from your dad. One gene copy is called an "allele".
+ - How your genes affect your body (called phenotype): in PGx, it usually shows if a gene version might cause a bad reaction to a medication or how fast your body processes a drug.
+
+
+ For more information about genetics please refer to the learn about genetics section, or in the app "More" > "Learn about genetics".
+
+
+Which medications does PharMe include?
+
+ PharMe includes medications that are known to be affected by genes. We get this information from clinical guidelines from CPIC and the FDA.
+
+
+
+ While only a small percentage of drugs have these guidelines, they are very commonly prescribed.
+
+
+ Some examples are medications for:
+
+
+ - Blood clots
+ - Depression
+ - High cholesterol
+ - Heartburn
+ - Pain
+ - Fungal infections
+ - Immune system
+ - Cancer
+
+
+Can other medications change my results?
+
+ Yes. Some medications can change how your body handles other medications. They can slow down or speed up how your body processes medications.
+
+PharMe will warn you when this might happen.
+
+ Medications that slow down how your body processes medications are called "inhibitors". Medications that speed these processes up are called "inducers". They can have a strong effect or a moderate effect on genes.
+
+
+ Please note that PharMe only changes your results if medications have a strong effect and only and warns you of medications have a moderate effect. Consult your pharmacist or doctor in such cases.
+
+
+ The following medications are included in PharMe that can change your results:
+
+
+Strong inhibitors:
+
+ - Bupropion (brand names: Aplenzin, Auvelity, Budeprion, Contrave, Forfivo, Wellbutrin, Zyban)
+ - Fluoxetine (brand names: Act Fluoxetine, Prozac, Sarafem, Symbyax)
+ - Paroxetine (brand names: Paxil, Pexeva)
+ - Quinidine (brand names: Nuedexta)
+ - Terbinafine (brand names: Lamisil, Silka Cream)
+
+Moderate inhibitors:
+
+ - Abiraterone (brand names: Yonsa, Zytiga)
+ - Cinacalcet (brand names: Sensipar, Mimpara)
+ - Duloxetine (brand names: Cymbalta, Drizalma, Irenka, Yentreve)
+ - Lorcaserin (brand names: Belvia)
+ - Mirabegron (brand names: Myrbetriq)
+
+
+Will my results affect my family?
+
+ Yes. Since genes run in families:
+
+ - You got your gene versions from your parents
+ - Your children will get their gene versions from you
+ - Your brothers and sisters might have similar gene versions
+
+
+
+Who should I share my results with?
+
+ Share your results with:
+
+ - Your doctors
+ - Your pharmacists
+ - Close family members
+
+ To share with healthcare providers, use the share button (top right of medication pages) to create a PDF.
+
+
+About the PharMe App
+
+
+What does PharMe do?
+PharMe helps you understand how your genes affect your medications.
+It shows which medications might not work well for you and might cause side effects.
+Always talk to your pharmacist or doctor before changing any medications.
+
+Can I use PharMe without talking to my doctor?
+
+ No. Always talk to your pharmacist or doctor before starting, changing, or stopping your medications.
+
+
+Where does PharMe get its information?
+
+ PharMe uses trusted guidelines from medical experts (CPIC and FDA). Our experts made these guidelines easier to understand without changing their meaning.
+
+
+Data Security
+
+
+How do you protect my gene information?
+
+ We keep your information safe by:
+
+ - Storing it only on your phone
+ - Never sharing it with others
+ - Doing all calculations on your phone
+ - Not storing any information that could tell us who you are
+ - Asking you to log in again if you do not use the app for some time
+
+
