Delivering a Pharmacogenetic Service: Is There a Role for Genetic Counselors?

Abstract

Pharmacogenetics, the use of genetic information to direct safer and or more effective prescription of medication, is a relatively new clinical concept. Currently, there is no consensus regarding which healthcare professionals should deliver pharmacogenetic services. This study explored the opinions of genetic counselors about their potential role in delivering pharmacogenetic services. Semi-structured face-to-face interviews were conducted with 14 genetic counselors. Four vignettes describing pharmacogenetic testing scenarios were used to elicit views on specific clinical applications. Data were analysed using the constant comparative method. Opinions varied, but the majority of interviewees suggested that genetic counselors could have a role. However, participants suggested that additional training would be needed due to counselors' limited knowledge of pharmacogenetics. Employing genetic counselors in a specialist role within a multidisciplinary clinic was suggested as a model of service delivery. Service models developed for pharmacogenetic testing may need to be adapted according to the issues presented by each type of test.

Pharmacogenomic knowledge gaps and educational resource needs among physicians in selected specialties

“…Similarly, genetic counselors have been proposed as an integral part of the pharmacogenomic delivery team because of their expertise in risk communication and counseling methodology 62. Genetic counselors may be particularly important when pharmacogenomic testing is undertaken to guide treatment for conditions that are genetic in nature 63. It should be noted that both pharmacists and genetic counselors may have pharmacogenomics knowledge deficits, and that they too require educational resources 62–65…”

Non‐Invasive Prenatal Testing: UK Genetic Counselors’ Experiences and Perspectives

“…This is highlighted by the recent American College of Medical Genetics (AGMC) guidelines in the returning of genome screen results and the ensuing discussion (Green et al 2013). Recent studies looking at GCs opinions on new technologies (Callard et al 2012;Grove et al 2013) show this group are contending with current advances as they move from research to the clinic and the new quandaries that arise from them. A recent commentator has described this current shift in practice as a move from "genetic" to "genomic" counseling (Ormondo 2013).…”

Clinical Delivery of Pharmacogenetic Testing Services: A Proposed Partnership Between Genetic Counselors and Pharmacists

“…Specifically, genetic counselors can play an important role informing and assisting physicians in the interpretation and communication of PGx information [12, 13] and addressing PGx testing in the context of disease susceptibility. In contrast, pharmacists can provide therapeutic support, serving as an educational resource and advising on drug selection, dose adjustment, and drug monitoring based on the PGx results and other clinical factors.…”

“…In a U.S. survey of genetic counselors, 52 percent of respondents believed that genetic counseling would be necessary for PGx testing [21] . Generally, though, genetic specialists, including genetic counselors, appear to perceive a limited role for themselves in pharmacogenetics [10, 12, 13, 21]. The perception of a limited role is due in part to the belief that PGx testing does not carry the same implications for patients as traditional genetic tests and would be routinely delivered as part of general care; thus, PGx testing would not require the same type of counseling offered for other genetics tests [10, 12].…”