Pharmacogenetic Information in Clinical Guidelines: The European Perspective

Abstract

Surveys among pharmacists and physicians show that these healthcare professionals have successfully adopted the concept of pharmacogenomics (PGx). In addition, patients are willing to consent to participate in PGx implementation studies. However, the surveys also show that healthcare professionals do not frequently order or recommend a PGx test. Among others, a frequently perceived hurdle for clinical uptake of PGx is the availability of guidelines translating PGx test results into clinical actions for individual patients..

Implementation and obstacles of pharmacogenetics in clinical practice: An international survey

“…Many US and Canadian laboratories now offer PGx testing, which is becoming more broadly incorporated into clinical care . In Europe, the number of laboratories offering PGx testing has significantly increased, and this has allowed broader access to PGx testing and more favourable turnaround time of test results . Other countries with lower HDI are still lagging behind as they need to overcome a number of barriers such as lack of funding, technology and infrastructure.…”

“…An example is the translational pharmacogenomic programme led by St Jude Children's Research Hospital (St Jude, Memphis, TN, USA), where PG4KDS is a project aimed at evaluating PGx test results in children and selectively choosing the tests that have strong evidence and closely linking them to drug response, in order to incorporate them into patient medical records . Although other such initiatives are already in place, albeit only in countries with very high HDI, further collaborations and communications between PGx experts and healthcare professionals are needed.

“[Need] practice guidelines from physician organizations, i.e.

…”

“…In cases where practitioners are not adequately trained, they would be assisted by a counsellor who understands and knows how to interpret PGx tests and results. In addition to physicians, multidisciplinary teams trained in PGx‐based drug selection and dosing can be of help in improving and disseminating PGx services offered to patients . For instance, the findings of a 2017 pilot study indicated that, in some clinical settings, pharmacists enhance the delivery of PGx testing by working with providers to interpret results appropriately …”

“…For instance, the Clinical Pharmacogenetics Implementation Consortium (CPIC) of the Pharmacogenomics Knowledgebase (PharmGKB) and the Dutch Pharmacogenetics Working Group have already contributed to guidelines and clinical annotation levels of evidence covering 100 gene–drug interactions, translating known genetic laboratory test results into concrete clinical decision‐making regarding drug prescribing . In addition, in 2015, the EU funded a large PGx implementation study that takes into consideration the large diversity of healthcare systems and languages of citizens across Europe …”

“…[7][8][9][10][11] In addition, in 2015, the EU funded a large PGx implementation study that takes into consideration the large diversity of healthcare systems and languages of citizens across Europe. 12 Despite these efforts, PGx clinical implementation may still be facing different challenges in different parts of the world. 3,[13][14][15][16] In addition, the majority of the documented efforts are concentrated in the USA and Europe, 12,15,17 while not much information is available from other parts of the world, with few exceptions.…”