The Emerging Role of Pharmacists in Pharmacogenomics

A special issue of Pharmacy (ISSN 2226-4787).

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 22292

Special Issue Editor


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Guest Editor
1. College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
2. Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
3. The Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
4. The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
Interests: pharmacogenomics; clinical pharmacy; clinical pharmacology; knowledge translation; implementation science; pharmacy education
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Special Issue Information

Dear Colleagues,

Pharmacogenomics (i.e., the study of how genes and drugs interact) has the potential to improve medication safety and effectiveness. Despite barriers, pharmacogenomic testing is now being implemented in more than 50 healthcare systems worldwide, and numerous options are available through commercial providers, including direct-to-consumer tests. Pharmacists, the drug experts and the most accessible healthcare professionals, are uniquely qualified and positioned to facilitate clinical implementation of pharmacogenomics. This Special Issue invites research articles addressing the emerging roles of pharmacists in the clinical implementation of pharmacogenomics. This can include but is not limited to:

  • Case studies;
  • Clinical trials in pharmacy settings;
  • Expert opinion pieces on the emerging roles of pharmacists in pharmacogenomics;
  • Facilitators and barriers of implementation;
  • Innovative pharmacy practice models;
  • Implementation models;
  • Ethical, legal, and social issues;
  • Pharmacogenomics in developing countries;
  • Innovative approaches to teach pharmacogenomics.

Dr. Abdullah Al Maruf
Guest Editor

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Keywords

  • pharmacists
  • pharmacogenomics
  • pharmacogenetics
  • personalized medicine
  • drug safety

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Published Papers (7 papers)

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Editorial

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5 pages, 542 KiB  
Editorial
The Potential Roles of Pharmacists in the Clinical Implementation of Pharmacogenomics
by Abdullah Al Maruf and Md. Abdul Aziz
Pharmacy 2023, 11(6), 180; https://doi.org/10.3390/pharmacy11060180 - 19 Nov 2023
Cited by 4 | Viewed by 4067
Abstract
The field of pharmacogenomics is at the forefront of a healthcare revolution, promising to usher in a new era of precision medicine [...] Full article
(This article belongs to the Special Issue The Emerging Role of Pharmacists in Pharmacogenomics)
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Research

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14 pages, 1080 KiB  
Article
An Integrated Multidisciplinary Circuit Led by Hospital and Community Pharmacists to Implement Clopidogrel Pharmacogenetics in Clinical Practice
by Joan Francesc Mir, Cristina Rodríguez-Caba, Maria Estrada-Campmany, Edurne Fernández de Gamarra-Martínez, Maria Antònia Mangues, Guillermo Bagaría and Pau Riera
Pharmacy 2023, 11(2), 76; https://doi.org/10.3390/pharmacy11020076 - 17 Apr 2023
Cited by 3 | Viewed by 2228
Abstract
The use of pharmacogenetics to optimize pharmacotherapy is growing rapidly. This study evaluates the feasibility and operability of a collaborative circuit involving hospital and community pharmacists to implement clopidogrel pharmacogenetics in Barcelona, Catalonia, Spain. We aimed to enroll patients with a clopidogrel prescription [...] Read more.
The use of pharmacogenetics to optimize pharmacotherapy is growing rapidly. This study evaluates the feasibility and operability of a collaborative circuit involving hospital and community pharmacists to implement clopidogrel pharmacogenetics in Barcelona, Catalonia, Spain. We aimed to enroll patients with a clopidogrel prescription from cardiologists at the collaborating hospital. Community pharmacists collected patients’ pharmacotherapeutic profiles and saliva samples, which were then sent to the hospital for CYP2C19 genotyping. Hospital pharmacists collated the obtained data with patients’ clinical records. Data were analyzed jointly with a cardiologist to assess the suitability of clopidogrel. The provincial pharmacists’ association coordinated the project and provided IT and logistic support. The study began in January 2020. However, it was suspended in March 2020 due to the COVID-19 pandemic. At that moment, 120 patients had been assessed, 16 of whom met the inclusion criteria and were enrolled in the study. The processing of samples obtained before the pandemic had an average delay of 13.8 ± 5.4 days. A total of 37.5% patients were intermediate metabolizers and 18.8% were ultrarapid metabolizers. No poor metabolizers were detected. Pharmacists rated their experience with a 7.3 ± 2.7 likelihood of recommending that fellow pharmacists participate. The net promoter score among participating pharmacists was +10%. Our results show that the circuit is feasible and operable for further initiatives. Full article
(This article belongs to the Special Issue The Emerging Role of Pharmacists in Pharmacogenomics)
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9 pages, 637 KiB  
Article
The Effect of Genotyping on the Number of Pharmacotherapeutic Gene–Drug Interventions in Chronic Kidney Disease Patients
by Catharina H. M. Kerskes, Carien J. M. E. van den Eijnde, Albert-Jan L. H. J. Aarnoudse, René J. E. Grouls, Birgit A. L. M. Deiman and Maarten J. Deenen
Pharmacy 2023, 11(2), 69; https://doi.org/10.3390/pharmacy11020069 - 4 Apr 2023
Cited by 4 | Viewed by 2223
Abstract
Patients with chronic kidney disease (CKD) stage 3–5 are polypharmacy patients. Many of these drugs are metabolized by cytochrome P450 (CYP450) and CYP450. Genetic polymorphism is well known to result in altered drug metabolism capacity. This study determined the added value [...] Read more.
Patients with chronic kidney disease (CKD) stage 3–5 are polypharmacy patients. Many of these drugs are metabolized by cytochrome P450 (CYP450) and CYP450. Genetic polymorphism is well known to result in altered drug metabolism capacity. This study determined the added value of pharmacogenetic testing to the routine medication evaluation in polypharmacy patients with CKD. In adult outpatient polypharmacy patients with CKD3-5 disease, a pharmacogenetic profile was determined. Then, automated medication surveillance for gene–drug interactions was performed based on the pharmacogenetic profile and the patients’ current prescriptions. Of all identified gene–drug interactions, the hospital pharmacist and the treating nephrologist together assessed clinical relevance and necessity of a pharmacotherapeutic intervention. The primary endpoint of the study was the total number of applied pharmacotherapeutic interventions based on a relevant gene–drug interaction. A total of 61 patients were enrolled in the study. Medication surveillance resulted in a total of 66 gene–drug interactions, of which 26 (39%) were considered clinically relevant. This resulted in 26 applied pharmacotherapeutic interventions in 20 patients. Systematic pharmacogenetic testing enables pharmacotherapeutic interventions based on relevant gene–drug interactions. This study showed that pharmacogenetic testing adds to routine medication evaluation and could lead to optimized pharmacotherapy in CKD patients. Full article
(This article belongs to the Special Issue The Emerging Role of Pharmacists in Pharmacogenomics)
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11 pages, 2139 KiB  
Article
Experience, Knowledge, and Perceptions of Pharmacogenomics among Pharmacists and Nurse Practitioners in Alberta Hospitals
by Meagan Hayashi and Chad A. Bousman
Pharmacy 2022, 10(6), 139; https://doi.org/10.3390/pharmacy10060139 - 26 Oct 2022
Cited by 11 | Viewed by 3075
Abstract
Background: Despite evidence of clinical utility and the availability of prescription guidelines, pharmacogenomics (PGx) is not broadly used in institutional settings in Canada. To inform future implementation, this study aimed to identify healthcare provider knowledge, experience, and perceptions of PGx in Alberta, Canada. [...] Read more.
Background: Despite evidence of clinical utility and the availability of prescription guidelines, pharmacogenomics (PGx) is not broadly used in institutional settings in Canada. To inform future implementation, this study aimed to identify healthcare provider knowledge, experience, and perceptions of PGx in Alberta, Canada. Methods: An online 44-item survey was distributed to pharmacists, nurse practitioners, and physicians employed or contracted with Alberta Health Services from January to May 2022. Questions included: demographics, professional history, PGx education and exposure, knowledge, and ability to use PGx, and attitudes towards, feasibility, clinical utility, education, and implementation. Results: Ninety-one pharmacists, 37 nurse practitioners, and 6 physicians completed the survey. Fifty-nine percent had 10 or more years of experience, and 71% practiced in urban settings. Only one-third had training in PGx, and one-quarter had used PGx. Most respondents (63%) had no knowledge of PGx resources, including the Pharmacogenomics Knowledge Base (75%), or the Clinical Pharmacogenetics Implementation Consortium guidelines (85%). While participants agreed that they understood genetic (75%) and PGx (63%) concepts, most disagreed with their ability regarding practical applications of PGx such as translating genotype to phenotype (74%) or counselling patients on results (66%). Participants agreed on the clinical utility of PGx in preventing adverse drug reactions (80%) and enhancing medication efficacy (77%), and identified oncology (62%), cardiovascular/stroke (60%), and psychiatry (56%) as therapeutic areas to consider implementation. At present, healthcare provider knowledge (87%), cost (81%), and limited guidelines/evidence (70%) are seen as the greatest barriers to implementation. Conclusion: Alberta healthcare providers have limited training, experience, or knowledge in PGx. However, most appear to have a positive outlook regarding clinical utility, especially within oncology, cardiology, and psychiatry. More effort is required to socialize the availability and quality of evidence and guidelines for the interpretation of PGx test results, address other knowledge gaps, and improve financial limitations. Full article
(This article belongs to the Special Issue The Emerging Role of Pharmacists in Pharmacogenomics)
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11 pages, 1045 KiB  
Article
A Guide to a Pharmacist-Led Pharmacogenetic Testing and Counselling Service in an Interprofessional Healthcare Setting
by Céline K. Stäuble, Chiara Jeiziner, Anna Bollinger, Florine M. Wiss, Martin Hatzinger, Kurt E. Hersberger, Thomas Ihde, Markus L. Lampert, Thorsten Mikoteit, Henriette E. Meyer zu Schwabedissen and Samuel S. Allemann
Pharmacy 2022, 10(4), 86; https://doi.org/10.3390/pharmacy10040086 - 19 Jul 2022
Cited by 11 | Viewed by 3768
Abstract
Genetic predisposition is one factor influencing interindividual drug response. Pharmacogenetic information can be used to guide the selection and dosing of certain drugs. However, the implementation of pharmacogenetics (PGx) in clinical practice remains challenging. Defining a formal structure, as well as concrete procedures [...] Read more.
Genetic predisposition is one factor influencing interindividual drug response. Pharmacogenetic information can be used to guide the selection and dosing of certain drugs. However, the implementation of pharmacogenetics (PGx) in clinical practice remains challenging. Defining a formal structure, as well as concrete procedures and clearly defined responsibilities, may facilitate and increase the use of PGx in clinical practice. Over 140 patient cases from an observational study in Switzerland formed the basis for the design and refinement of a pharmacist-led pharmacogenetics testing and counselling service (PGx service) in an interprofessional setting. Herein, we defined a six-step approach, including: (1) patient referral; (2) pre-test-counselling; (3) PGx testing; (4) medication review; (5) counselling; (6) follow-up. The six-step approach supports the importance of an interprofessional collaboration and the role of pharmacists in PGx testing and counselling across healthcare settings. Full article
(This article belongs to the Special Issue The Emerging Role of Pharmacists in Pharmacogenomics)
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9 pages, 222 KiB  
Article
Investigation of Biomedical Students’ Attitudes toward Pharmacogenomics and Personalized Medicine: A Cross-Sectional Study
by Josipa Bukic, Doris Rusic, Dario Leskur, Ana Seselja Perisin, Tin Cohadzic, Marko Kumric, Josko Bozic and Darko Modun
Pharmacy 2022, 10(4), 73; https://doi.org/10.3390/pharmacy10040073 - 28 Jun 2022
Cited by 5 | Viewed by 2094
Abstract
Background: The utilization of pharmacogenomics in everyday practice has shown several notable benefits. Keeping in mind the rising trend of applicability of pharmacogenomics and personalized medicine, we sought to compare the attitudes of future healthcare workers in different branches of the healthcare system. [...] Read more.
Background: The utilization of pharmacogenomics in everyday practice has shown several notable benefits. Keeping in mind the rising trend of applicability of pharmacogenomics and personalized medicine, we sought to compare the attitudes of future healthcare workers in different branches of the healthcare system. Methods: The present study was conducted as a questionnaire-based cross-sectional study in October of 2020. Students eligible to participate were all the students of the University of Split School of Medicine enrolled in the academic year 2020/2021. Results: The number of students that participated in the study was 503. Students were most interested in clinical examples of pharmacogenomics (31.4%) and the benefits of pharmacogenomics in clinical practice (36.4%). Furthermore, 72.6% of all students agreed that they should be able, in their future practice, to identify patients that could benefit from genetic testing. Conclusion: At the present time, the lack of education and appropriate clinical guidelines appear to be the major barriers to the clinical application of pharmacogenomics, especially in Croatia. Hence, in order to support health care professionals’ evidence-based therapeutic recommendations with patients’ pharmacogenomic data, universities should offer more pharmacogenomics education in their curricula. Full article
(This article belongs to the Special Issue The Emerging Role of Pharmacists in Pharmacogenomics)

Review

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17 pages, 1250 KiB  
Review
The Critical Role of Pharmacists in the Clinical Delivery of Pharmacogenetics in the U.S
by Susanne B. Haga
Pharmacy 2023, 11(5), 144; https://doi.org/10.3390/pharmacy11050144 - 10 Sep 2023
Cited by 4 | Viewed by 2752
Abstract
Since the rebirth of pharmacogenomics (PGx) in the 1990s and 2000s, with new discoveries of genetic variation underlying adverse drug response and new analytical technologies such as sequencing and microarrays, there has been much interest in the clinical application of PGx testing. The [...] Read more.
Since the rebirth of pharmacogenomics (PGx) in the 1990s and 2000s, with new discoveries of genetic variation underlying adverse drug response and new analytical technologies such as sequencing and microarrays, there has been much interest in the clinical application of PGx testing. The early involvement of pharmacists in clinical studies and the establishment of organizations to support the dissemination of information about PGx variants have naturally resulted in leaders in clinical implementation. This paper presents an overview of the evolving role of pharmacists, and discusses potential challenges and future paths, primarily focused in the U.S. Pharmacists have positioned themselves as leaders in clinical PGx testing, and will prepare the next generation to utilize PGx testing in their scope of practice. Full article
(This article belongs to the Special Issue The Emerging Role of Pharmacists in Pharmacogenomics)
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