The critical role of pharmacists in pharmacogenomics
We are at an inflection point in precision prescribing. Increasingly, the medical community is recognizing the science and evidence in favor of pharmacogenomics (PGx), but there is a gap in understanding how to effectively implement PGx programs and incorporate results into patient care. Pharmacists are in a unique position to accelerate the growth and adoption of PGx - both in their organizations and throughout the medical community.
Pharmacists and pharmacogenomics go hand in hand
PGx information can add a great deal of value to patient care. Having access to PGx results can help providers identify medications and dosages that may work well for a given patient, based on their DNA. This, in turn, can help providers reduce trial and error in prescribing, lower the likelihood of adverse drug events, and give patients greater confidence in their medications.
With their understanding of drugs and existing role in medication interventions - including dosing, drug-drug interactions, and medication management programs - pharmacists can be instrumental partners to providers in the implementation of PGx.
How pharmacists can lead in pharmacogenomics
One of the most important roles pharmacists have in PGx is in interpretation of results. It isn’t enough to know that a patient is, for example, a poor metabolizer at CYP2C19. Pharmacists have the knowledge and context to turn that phenotype information into therapy recommendations, including:
- Whether a dosage adjustment is appropriate for the patient or an alternative medication should be prescribed
- Which alternative medications may provide the same therapeutic effect but are processed by enzymes encoded on different genes
- How concurrent medications may affect medication and dosage selection
- The impact that age, weight, tobacco use, and other factors may have on medication efficacy
- Which medications and dosages are most likely to be optimal for a given patient based on the combination of their PGx profile, medication history, and physical and environmental factors
While interpreting results is a valuable contribution, pharmacists’ functional role in PGx is much greater. According to the American Society of Health-System Pharmacists, pharmacists should be involved in recommending or scheduling PGx testing for patients, making medication and dosage recommendations based on PGx results, and educating patients and colleagues about PGx and its clinical applications.
The time is now
As precision prescribing becomes increasingly ingrained in patient care, pharmacists are more important than ever. Their expertise is valuable in interpreting PGx results and they have the understanding to support providers in applying PGx insights to prescribing decisions. By bridging the gap between science and clinical application, pharmacists can help providers and their patients realize the benefits of PGx testing.