Transitioning Pharmacogenomics into the Clinical Setting: Training Future Pharmacists

Abstract

Pharmacogenomics, once hailed as a futuristic approach to pharmacotherapy, has transitioned to clinical implementation. Although logistic and economic limitations to clinical pharmacogenomics are being superseded by external measures such as preemptive genotyping, implementation by clinicians has met resistance, partly due to a lack of education. Pharmacists, with extensive training in pharmacology and pharmacotherapy and accessibility to patients, are ideally suited to champion clinical pharmacogenomics. This study aimed to analyze the outcomes of an innovative pharmacogenomic teaching approach. Second-year student pharmacists enrolled in a required, 15-week pharmaceutical care lab course in 2015 completed educational activities including lectures and small group work focusing on practical pharmacogenomics. Reflecting the current landscape of direct-to-consumer (DTC) genomic testing, students were offered 23andMe genotyping. Students completed surveys regarding their attitudes and confidence on pharmacogenomics prior to and following the educational intervention. Paired pre- and post-intervention responses were analyzed with McNemar's test for binary comparisons and the Wilcoxon signed-rank test for Likert items. Responses between genotyped and non-genotyped students were analyzed with Fisher's exact test for binary comparisons and the Mann-Whitney U-test for Likert items. Responses were analyzed for all student pharmacists who voluntarily completed the pre-intervention survey (N = 121, 83% response) and for student pharmacists who completed both pre- and post-intervention surveys (N = 39, 27% response). Of those who completed both pre- and post-intervention surveys, 59% obtained genotyping. Student pharmacists demonstrated a significant increase in their knowledge of pharmacogenomic resources (17.9 vs. 56.4%, p < 0.0001) and confidence in applying pharmacogenomic information to manage patients' drug therapy (28.2 vs. 48.7%, p = 0.01), particularly if the student had received genotyping. Student pharmacists understanding of the risks and benefits of using personal genome testing services significantly increased (55.3 vs. 86.8%, p = 0.001) along with agreement that personal genomics would likely play an important role in their future career (47.4 vs. 76.3%, p = 0.01), particularly among students who participated in genotyping. The educational intervention, including personal genotyping, was feasible, and positively enhanced students' reflections, and attitudes toward pharmacogenomics in a professional pharmacy program.

Implementing Pharmacogenomics in Europe: Design and Implementation Strategy of the Ubiquitous Pharmacogenomics Consortium

“…There have been advances in PGx implementation, but significant barriers remain, including those preventing clinical implementation . The remaining hurdles include improving physician and pharmacist awareness and education about PGx, the development of tools to implement PGx results into the workflow of physicians and pharmacists, and the undecided reimbursement of PGx tests. Finally, and most importantly, evidence presenting the collective clinical utility of a panel of PGx‐markers remains to be established.…”

Perceptions of students in health and molecular life sciences regarding pharmacogenomics and personalized medicine

“…Previous studies have shown that incorporating active learning experiences in PG would increase student interests [ 54 ]. Additional innovative learning methods in PG have been recently adopted, such as Pharmacogenomics Education Program 3 (PharmGenEd™) open online courses [ 9 ] and personal genotyping [ 52 , 55 , 56 ]. When teaching PG through practical applications, students learn to use genetic information in the framework of medication management, allowing them to understand the significance of PG applications in clinical practice [ 51 ].…”

Implementation of Pharmacogenetics in Primary Care: A Multi-Stakeholder Perspective

“…Barriers and facilitators of implementation of pharmacogenetics into health care have been widely studied (Deverka et al, 2007;Swen et al, 2007;Haga and Burke, 2008;Altman et al, 2011;Ieiri, 2012;Bell et al, 2014;Perry et al, 2016;Frick et al, 2016;Hicks et al, 2016;Abbasi, 2016;Kapoor et al, 2016). Main hurdles that are described include the need for improvement in physician and pharmacist awareness and education about PGx, more insight in relevant measures for clinical validity and utility of (preemptive) PGx testing (Tonk et al, 2017;Jansen et al, 2017), and a proper infrastructure to integrate pharmacogenetics into the workflow of physicians and pharmacists (van der Wouden et al, 2017;Slob et al, 2018).…”