Nurses’ Communication of Pharmacogenetic Test Results as Part of Discharge Care

Haga, Susanne B.; Mills, Rachel

doi:10.2217/pgs.14.173

Cited by 11 publications

(7 citation statements)

References 47 publications

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“…Finally, it should be pointed out that nurses as a group of providers were relatively under-represented among the articles that were reviewed in this study. However, they fulfill an important role in educating and informing patients about pharmacogenomic tests (Calzone et al, 2010; Haga & Mills, 2015). Some centers even have a nurse who can meet and follow-up with patients and their loved ones.…”

Section: Discussionmentioning

confidence: 99%

Patient and Health Care Provider Needs and Preferences in Understanding Pharmacogenomic and Genomic Testing: A Meta-Data Analysis

2019

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Tests that feature genomic indicators can now be used to guide the pharmacological treatment of patients. To better identify the needs and preferences of patients and health care providers in facilitating their understanding of information related to such pharmacogenomic tests (PGx), a review of literature on knowledge translation and health literacy in the context of testing was conducted. Using a grounded theory-based approach, a comparative analysis of data from 36 studies meeting the criteria for the meta-data analysis has revealed the recurrence of three principal themes: (a) knowledge and understanding of genetics and pharmacogenomics; (b) experiences with genetic, genomic, or PGx testing (decision about the test, information delivery, and understanding of test results); and (c) educational/informational resources. This synthesis sheds light on each theme from the standpoint of both patients and health care providers and suggests avenues in which to direct efforts to support the introduction of pharmacogenomic tests in current practice.

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Section: Discussionmentioning

confidence: 99%

Patient and Health Care Provider Needs and Preferences in Understanding Pharmacogenomic and Genomic Testing: A Meta-Data Analysis

2019

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“…Clinicians could use normal metabolic profile results to reassure patients of the safety of the drugs prescribed and likelihood to work for them, thereby potentially promoting adherence. In addition, SCD patients could share their pharmacogenetic results with their other health provider to ensure optimal prescribing for future medications (Haga and Mills, 2015). To be sure, the utility of genotype-guided prescribing practice for CYP2C19 substrates in SCD patients will depend on CYP2C19 enzyme expression, and genotype-metabolic phenotype concordance, which may be influenced by SCD.…”

Section: Discussionmentioning

confidence: 99%

Progressing Preemptive Genotyping of CYP2C19 Allelic Variants for Sickle Cell Disease Patients

Jaja

Barrett

Patel

et al. 2016

Genetic Testing and Molecular Biomarkers

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Aims: Interindividual variability in drug response and adverse effects have been described for proton pump inhibitors, anticonvulsants, selective serotonin reuptake inhibitors, tricyclic antidepressants, and anti-infectives, but little is known about the safety and efficacy of these medications in patients with sickle cell disease (SCD). We genotyped the CYP2C19 gene which has been implicated in the metabolism of these drugs in an SCD patient cohort to determine the frequencies of reduced function, increased function, or complete loss-of-function variants. Materials and Methods: DNAs from 165 unrelated SCD patients were genotyped for nine CYP2C19 (*2, *3, *4, *5, *6, *7,*8, *12, and *17) alleles using the iPLEX Ò ADME PGx multiplex panel. Results: Three CYP2C19 alleles (*2, *12, and *17) were detected with the following frequencies: 0.209, 0.006, and 0.236, respectively. The predicted phenotype frequencies were distributed as extensive (31.5%), intermediate (24.8%), poor (5.5%), ultrarapid (30.3%), and unknown metabolizers (7.9%). Discussion: Prognostic genotyping is potentially useful for identifying SCD patients with allelic variants linked to proven clinical pharmacokinetic consequences for several drugs metabolized by the CYP2C19 gene. However, the main challenge to implementing a genetics-guided prescribing practice is ensuring concordance between CYP2C19 genotypes and metabolic phenotypes in SCD patients.

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“…66 In addition, it is still unknown what specific skill sets are needed by each care team member in order to discuss a patient's PGx testing results. 67 These reported knowledge and confidence gaps create an imperative to ensure healthcare teams are adequately prepared to support a healthcare model where prescribing is based on the results of PGx testing.…”

Section: Pharmacogenomics Knowledge and Educationmentioning

confidence: 99%

<p>Concepts Driving Pharmacogenomics Implementation Into Everyday Healthcare</p>

Giri¹,

Moyer²,

Bielinski³

et al. 2019

PGPM

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Pharmacogenomics (PGx) is often promoted as the domain of precision medicine with the greatest potential to readily impact everyday healthcare. Rapid advances in PGx knowledge derived from extensive basic and clinical research along with decreasing costs of laboratory testing have led to an increased interest in PGx and expectations of imminent clinical translation with substantial clinical impact. However, the implementation of PGx into clinical workflows is neither simple nor straightforward, and comprehensive processes and multidisciplinary collaboration are required. Several national and international institutions have pioneered models for implementing clinical PGx, and these initial models have led to a better understanding of unresolved challenges. In this review, we have categorized and explored the most relevant of these challenges to highlight potential gaps and present possible solutions. We describe the ongoing need for basic and clinical research to drive further developments in evidence-based medicine. Integration into daily clinical workflows introduces new challenges requiring innovative solutions; specifically those related to the electronic health record and embedded clinical decision support. We describe advances in PGx testing and result reporting and describe the critical need for increased standardization in these areas across laboratories. We also explore the complexity of the PGx knowledge required for clinical practice and the need for educational strategies to ensure adequate understanding among members of current and future healthcare teams. Finally, we evaluate knowledge obtained from previous implementation efforts and discuss how to best apply these learnings to future projects. Despite these challenges, the future of precision medicine appears promising due to the rapidity of recent advances in the field and current multidisciplinary efforts to effectively translate PGx to everyday clinical practice.

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Nurses’ Communication of Pharmacogenetic Test Results as Part of Discharge Care

Cited by 11 publications

References 47 publications

Patient and Health Care Provider Needs and Preferences in Understanding Pharmacogenomic and Genomic Testing: A Meta-Data Analysis

Patient and Health Care Provider Needs and Preferences in Understanding Pharmacogenomic and Genomic Testing: A Meta-Data Analysis

Progressing Preemptive Genotyping of CYP2C19 Allelic Variants for Sickle Cell Disease Patients

<p>Concepts Driving Pharmacogenomics Implementation Into Everyday Healthcare</p>

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