Perspectives of a pharmacist‐run pharmacogenomic service for depression in interdisciplinary family medicine practices

Abstract

Objectives Pharmacists in primary care practices are uniquely positioned to use pharmacogenomic data to drive personalized medical treatment for patients with depression. To date, there are limited data exploring the implementation and utility of a pharmacist‐run pharmacogenomic service within physician office practices. This project explored pharmacist and physician perspectives on how to implement a pharmacist‐run pharmacogenomic service to optimize pharmacotherapy and aid in informed decision‐making when initiating treatment for depression in primary care practices. Methods Family medicine physicians and their associated pharmacists were invited via email to participate in semi‐structured, key informant interviews with a pharmacist investigator. Interview questions were informed using the Consolidated Framework for Implementation Research. Interviews were audio recorded and transcribed. Transcripts were independently coded by two investigators. Coding discrepancies were resolved. A thematic analysis was performed. Results Twenty‐one interviews were conducted. Six major themes emerged upon analysis: (1) Utilizing pharmacogenomics in the primary care setting may be a tool to help individualize initial medication selection for patients with depression; (2) Implementing a pharmacist‐driven pharmacogenomics service begins with a prescriber‐patient interaction and includes a subsequent team‐based approach with open lines of communication; (3) Trained pharmacists who have collaborative relationships with an outpatient physician practice should interpret pharmacogenomic results and select appropriate pharmacotherapy; (4) Appropriate patient selection, engagement, and education are critical factors to consider when designing a pharmacist‐driven pharmacogenomics service; (5) Patient monitoring and follow‐up responsibilities will be shared amongst team members and; (6) Education on Interpretation and Implementation of Pharmacogenomic Data for the Treatment of Depression is Necessary for Health Care Professionals. Conclusions Physicians and pharmacists view pharmacogenomics as a useful tool to individualize pharmacotherapy for patients with depression. Team‐based care is required for patient engagement, effective communication, and follow‐up. Pharmacists are key team members who will interpret pharmacogenomic results and provide requisite recommendations.

Genomics and Pharmacogenomics Knowledge, Attitude and Practice of Pharmacists Working in United Arab Emirates: Findings from Focus Group Discussions—A Qualitative Study

“…Several studies evaluated the knowledge and attitude of pharmacists toward genomics and pharmacogenomics world-wide and our study is the first to do so in the UAE. Despite the geographical spaces, pharmacists shared similar attitudes and concerns toward pharmacogenomics [ 8 , 9 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. In our sample, the knowledge of pharmacists who worked or studied outside the UAE did not differ from those who worked or studied in the UAE.…”

Pharmacogenomics guided versus standard antidepressant treatment in a community pharmacy setting: A randomized controlled trial

“…22 Recently, a more active role has been argued for pharmacists in pharmacogenomic testing. 25 Pharmacists may be ideally positioned to interpret pharmacogenomic testing profiles and provide recommendations, owing to their specialized training in pharmacology. [25][26][27] Indeed, previous research suggests that involvement of pharmacists in depression management, including through patient education and counselling, can improve adherence to antidepressant medications.…”

“… 25 Pharmacists may be ideally positioned to interpret pharmacogenomic testing profiles and provide recommendations, owing to their specialized training in pharmacology. 25 , 26 , 27 Indeed, previous research suggests that involvement of pharmacists in depression management, including through patient education and counselling, can improve adherence to antidepressant medications. 27 Moreover, recent work leveraging prescription dispensing data in community pharmacies in the Netherlands estimated that approximately one out of four new prescriptions of common primary care medications will have an actionable gene‐drug interaction, 28 highlighting the potential impact of pharmacogenomic testing in this setting.…”

“…Recently, a more active role has been argued for pharmacists in pharmacogenomic testing 25 . Pharmacists may be ideally positioned to interpret pharmacogenomic testing profiles and provide recommendations, owing to their specialized training in pharmacology 25–27 .…”

The Role of Board-Certified Psychiatric Pharmacists in Expanding Access to Care and Improving Patient Outcomes

“…Pharmacists could be collaboratively called on to support appropriate use of pharmacogenomic information in individual care decisions and to provide assistance in designing health system policies and procedures for genetic testing and management of genetic data. Responsibilities could include testing recommendations for specific medications and individuals, interpreting results, recommending medication therapies, and providing a rationale for discouraging testing when evidence-based decisions will not be helped by testing (73).…”