Pharmacists have the opportunity to play a key role in pharmacogenetic (PGx) testing. Many are motivated to expand training opportunities and curriculum to prepare others to participate in this expanded role.
The field of pharmacogenetics allows for pharmacists to create a personalized medication regimen for their patients based on their genetic makeup and clinical information. This offers increased safety and efficiency for patients. Some medications on the market already have pharmacogenetic data to assist the right dosing and selection. Further, pharmacogenetic analyses are regularly conducted during drug development.1 The field of genomic medicine gives a possible solution to negate health care costs associated with adverse drug events and poor response to pharmacotherapy.
As evidence builds for the clinical advantages of PGx testing, so have swift and accurate testing platforms and business interest, fostering debate and discussion around delivery options. Although PGx testing has been available for years, there are still many issues related to implementation of PGx testing, including:
- evidence of clinical utility of testing,
- provider preparedness,
- integration of testing into clinical workflow,
- clinical decision support,
- reimbursement, and
- availability of patient resources to promote engagement.
Each clinical setting will likely raise unique barriers to implementation, according to the study.2,3
The study evaluated the viability of pharmacist delivered PGx testing in an independent community pharmacy setting. Participating pharmacists were surveyed before and after the study and then semi-structured interviews were conducted. The findings suggested methods of increasing independent pharmacist involvement in the delivery of PGx testing through identification of some practice shortcomings in this setting.2
Independent community pharmacies in North Carolina were randomized to give either PGx testing as an independent service or combined into medication therapy management services. There were 36 pharmacists from 22 pharmacy locations included in the study. Approximately 31% of pharmacists had received education in personalized medicine or PGx prior to the study. Pharmacists’ knowledge about PGx significantly improved post-study, investigators found.
In the post-study survey, almost all pharmacists indicated that they felt qualified to give PGx testing at their pharmacy and 75% of pharmacists said that they may continue to provide PGx testing at their pharmacy following the conclusion of the study.
However, pharmacists cited a lack of reimbursement for PGx counseling and consultation as a major concern, which can impact long-term delivery of PGx testing. Pharmacists can assist in the delivery of PGx testing through a consultation service, assisting with test ordering and interpretation of test results. Pharmacogenetic testing offered in combination with medication therapy management also allows consideration of the patient’s medication history, adverse events (AEs) and drug and gene interactions. The inclusion of PGx testing allows for the identification of clinically important drug to drug interactions through recognition of phenoconversion. Pharmacist-delivered PGx testing with medication therapy management has been reported to reduce costs for elderly patients.2,3
The findings of the study revealed a positive outcome of delivering PGx testing in the community pharmacy setting. Pharmacists surveyed were confident in their ability to give PGx testing and were interested in continuing to offer testing.
- Moaddeb J, Haga SB. Pharmacogenetic testing: Current evidence of clinical utility. Therapeutic Advances in Drug Safety. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3765014/. Published August 1, 2013. Accessed August 19, 2021.
- Haga SB, Mills R, Moaddeb J, Liu Y, Voora D. Delivering pharmacogenetic testing- pharmacist experiences: Pgpm. Pharmacogenomics and Personalized Medicine. https://www.dovepress.com/independent-community-pharmacists-experience-in-offering-pharmacogenet-peer-reviewed-fulltext-article-PGPM. Published July 15, 2021. Accessed August 19, 2021.
- Mills R, Voora D, Peyser B, Haga SB. Delivering pharmacogenetic testing in a primary care setting. Pharmacogenomics and personalized medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3791676/. Published September 18, 2013. Accessed August 19, 2021.