No abstract

24Objective: To evaluate if pharmacy students' participation in personal pharmacogenetic 25 (Pgx) testing enhances their knowledge and attitude towards precision medicine (PM). 26 Methods: First-year pharmacy students were offered personalized pharmacogenetic 27 testing as a supplement to a required curricular pharmacogenomics course. Ninety-28 eight of 122 (80%) students completed pre-and post-course surveys assessing 29 knowledge and attitudes regarding PM; 73 students also volunteered for personal 30 pharmacogenetic testing of the following drug metabolizing enzymes (CYP2C19, 31 CYP2D6, UGT1A1) and pharmacodynamics-relevant proteins (interleukin (IL)-28B & 32 human lymphocyte antigen HLAB*5701). 33 Results: Using a linear mixed effects model, we observed statistically significant 34 improvements in 100% of knowledge and 70% of attitude-related questions for students 35 who decided to undergo personal pharmacogenetic testing. 36 Conclusion: Personal pharmacogenetic testing significantly enhances knowledge of 37 and attitude related to precision medicine among PharmD trainees. This study 38 demonstrates the feasibility and importance of educating future pharmacists by 39 incorporating pharmacogenetic testing into professional school curricula. 40 41

Background Pharmacists represent some of the most accessible healthcare workers and are in an opportune position to spearhead new clinical initiatives, such as pharmacogenomics (PGx) services. It is important that we understand the perceptions and attitudes both pharmacists and patients have regarding PGx and potential barriers of implementing it into routine clinical practice. Methods A cross-sectional survey study was conducted across one regional division of a large community pharmacy chain to assess the perceptions and attitudes of pharmacists and patients regarding PGx in California. A secondary aim was to determine perceived barriers to PGx implementation into community pharmacies. Results The majority (67%) of pharmacists agreed or strongly agreed to understanding PGx compared to 35% of patients being aware of PGx (p<0.001). More patients (62%) preferred their pharmacist compared to pharmacists (43%) preferring themselves as a provider to manage patients' medications based on their PGx results (p<0.01). Many patients (88%) expressed interest in participating in a PGx test; both pharmacists (84%) and patients (85%) were unlikely to have participated or know someone who has participated in PGx testing. Pharmacists and patients expressed similar concerns about privacy of their PGx data by employers (p=0.287) and insurers (p=0.953), a potential barrier to PGx implementation. Conclusion Pharmacists are well positioned to spearhead PGx consultations and patients are interested in pharmacists using PGx to help manage their medications; however, various barriers were identified that must be overcome for PGx to become incorporated in routine practice.

Purpose The purpose of this study was to determine the impact of food on gastric pH and the ability of over the counter betaine hydrochloride (BHCl) acid to reacidify gastric pH after food-induced elevations in gastric pH. Methods This open-label cross over clinical study (NCT02758015) included 9 subjects who were randomly assigned to one of 16 possible, 4-period cross-over sequences to determine the impact and relationship of food and gastric pH with acid supplementation. Subjects were administered various doses (1500 mg, 3000 mg and 4500 mg) of betaine hydrochloride (BHCl) to determine the ability of acid supplementation to reacidify gastric pH after the elevation of gastric pH caused by the ingestion of food. Results Following the administration of food and the resulting elevation in gastric pH, time to return to baseline gastric pH levels without acid supplementation was 49.7 ± 14.0 min. Administering 4500 mg of BHCl acid in capsules was able to reacidify gastric pH levels back to baseline following the administration of food in approximately 17.3 ± 5.9 min. AUC pH of each treatment were similar and not statistically different. Mean max pH following the administration of food was 3.20 ± 0.55. Conclusion The ability of food to elevate and maintain gastric pH levels in the presence of acid supplementation was made evident throughout the study. A 4500 mg dose of BHCl was required to reacidify gastric pH after the administration of food. This study details the difficulty faced by clinicians in dosing a poorly soluble, weakly basic drug to patients receiving acid reducing agents where administration with food is recommended to avoid gastric side effects. Trial Registration: https://clinicaltrials.gov/ct2/show/ NCT02758015 KEY WORDS betaine hydrochloride . gastric pH . gastric reacidification . meal effects ABBREVIATIONS ARA Acid reducing agent BHCl Betaine hydrochloride GERD Gastroesophageal reflux disease PPI Proton pump inhibitor