Pharmacists play key roles in clinical pharmacogenomics
The role of the pharmacist in implementing pharmacogenomic data into clinical care is increasingly being recognized. Pharmacists are uniquely qualified to provide input and leadership in this area due to their medication-related knowledge and experience. However, necessary roles and responsibilities for pharmacists are still being developed in this field.
Owusu-Obeng* and colleagues described potential roles and responsibilities for pharmacists that emerged during the first year of the UF Health Personalized Medicine Program (PMP) in a recent practice insight article published in Pharmacotherapy. Authors described pharmacists’ responsibilities in a pharmacist-led clinical pharmacogenomics program that started in 2012 with CYP2C19-genotype guided clopidogrel therapy in patients undergoing percutaneous coronary intervention.
Pharmacists’ roles and responsibilities within this program in the first year included:
- Medication-use policies and processes: Planning and implementing formulary changes under the purview of the Pharmacy and Therapeutics Committee
- Literature evaluation and application of evidence-based medicine: Conducting evaluation and interpretation of pharmacogenomics literature necessary to define and support genotype-guided therapy
- Pharmacy informatics: Developing and implementing clinical decision support within the electronic health record
- Direct patient care: Providing clinical pharmacist support to guide drug therapy changes resulting from genotype information
- Response to medication safety needs: Following medication safety trends to formulate responses or strategies that incorporate genotype-guided therapy when appropriate
- Research and ethical issues: Providing input on patient research and ethical questions that arise with clinical use of genomic data
- Design and implementation of professional education programs: Developing and implementing targeted and broad-based educational programs to help facilitate practice change
This article provides a potential framework for pharmacists’ responsibilities in an institution interested in developing clinical pharmacogenomics services. However, authors cited areas of need within the profession to further support growth and uptake of the pharmacist as a clinical leader in pharmacogenomics. Continued focus on “development and delivery of pharmacist education and training, provision of practical clinical implementation resources, and creation and dissemination of sustainable business models to support pharmacists’ expanded roles” will be essential to growth in this area, study authors wrote.
Pharmacy professional associations are stepping up to provide this support in a number of ways. A recently appointed Pharmacogenomics Task Force in the American College of Clinical Pharmacy is developing advisory recommendations for the college; the American Society of Health-System Pharmacists is set to publish their statement on the pharmacist’s role in clinical pharmacogenomics by end of 2014; an American Pharmacists Association white paper proposes a practice model in which pharmacogenomics is integrated into medication therapy management services and APhA DrugInfoLine*regularly includes a pharmacogenomics column. The American Association of Colleges of Pharmacy also supports educators through its pharmacogenomics faculty Special Interest Group.
Web-based educational and practice resources are also available for pharmacists, including the Pharmacogenomics Knowledgebase and the pharmacists’ section of the Genetics and Genomics Competency Center, funded by the National Institutes of Health. The Institute of Medicine’s Roundtable on Translating Genomic-Based Research for Health also has convened an action collaborative to provide practical recommendations and solutions for incorporating pharmacogenomic information into patient electronic health records.
Owusu Obeng A et al. Emerging roles for pharmacists in clinical implementation of pharmacogenomics. Pharmacotherapy. 2014;34(10):1102-12.
*Editorial note: SNP•its Editor Kristin Weitzel is an author on this manuscript and Editor-in-Chief of APhA DrugInfoLine.