Considerations When Applying Pharmacogenomics to Your Practice

Nicholson, Wayne T.; Formea, Christine M.; Matey, Eric T.; Wright, Jessica A.; Giri, Jyothsna; Moyer, Ann M.

doi:10.1016/j.mayocp.2020.03.011

Cited by 28 publications

(14 citation statements)

References 82 publications

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“…Therefore, stakeholders planning a PGx workshop for pharmacists need to know their audience in regard to demographic, role, occupation, prior knowledge and experiences. We hypothesize that this will be a cost-effective PGx literacy approach [ 41 – 43 ]. A study by Owusu‐Obeng et al explored the role of pharmacists in the PGx era and the findings aligned with ours.…”

Section: Discussionmentioning

confidence: 99%

Development of the pharmacogenomics and genomics literacy framework for pharmacists

et al. 2021

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Background Pharmacists play a unique role in integrating genomic medicine and pharmacogenomics into the clinical practice and to translate pharmacogenomics from bench to bedside. However, the literature suggests that the knowledge gap in pharmacogenomics is a major challenge; therefore, developing pharmacists’ skills and literacy to achieve this anticipated role is highly important. We aim to conceptualize a personalized literacy framework for the adoption of genomic medicine and pharmacogenomics by pharmacists in the United Arab Emirates with possible regional and global relevance. Results A qualitative approach using focus groups was used to design and to guide the development of a pharmacogenomics literacy framework. The Health Literacy Skills framework was used as a guide to conceptualize the pharmacogenomics literacy for pharmacists. The framework included six major components with specific suggested factors to improve pharmacists’ pharmacogenomics literacy. Major components include individual inputs, demand, skills, knowledge, attitude and sociocultural factors. Conclusion This framework confirms a holistic bottom-up approach toward the implementation of pharmacogenomics. Personalized medicine entails personalized efforts and frameworks. Similar framework can be created for other healthcare providers, patients and stakeholders.

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Section: Discussionmentioning

confidence: 99%

Development of the pharmacogenomics and genomics literacy framework for pharmacists

et al. 2021

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“…More general discussion about overcoming challenges of implementing pharmacogenetics are beyond the scope of this study but are available in other studies. 55,56,59,60 The clinical utility for genotypeguided pain management is currently limited to tramadol and codeine, as well as for several NSAIDs, but data for hydrocodone are increasing. If these medications are not being considered to treat the patient's pain, then pharmacogenetic testing may not be helpful at that time.…”

Section: "How To" Guide On Implementing Pharmacogenetics-guided Pain Managementmentioning

confidence: 99%

Pharmacogenetics: A precision medicine approach to combatting the opioid epidemic

Smith

Stevenson

Cooper-DeHoff

et al. 2021

J Am Coll Clin Pharm

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Ineffective pain control is the most commonly cited reason for misuse of prescription opioids and is influenced by genetics. In particular, the gene encoding the CYP2D6 enzyme, which metabolizes some of the most commonly prescribed opioids (eg, tramadol, hydrocodone) to their more potent forms, is highly polymorphic and can lead to reduced concentrations of the active metabolites and decreased opioid effectiveness. Consideration of the CYP2D6 genotype may allow for predicting opioid response and identifying patients who are likely to respond well to lower potency opioids as well as those who may derive greater pain relief from nonopioid analgesics vs certain opioids. There is emerging evidence that a CYP2D6-guided approach to pain management improves pain control and reduces opioid consumption and thus may be a promising means for combating opioid misuse. Clinical practice guidelines are available for select opioids and other analgesics to support medication and dose selection based on pharmacogenetic data. This article describes the evidence supporting genotype-guided pain management as a means of improving pain control and reducing opioid misuse and clinical recommendations for genotype-guided analgesic prescribing. In addition, a "how to" guide using patient case examples is provided to demystify the process for implementing pharmacogenetics-guided pain management to optimize analgesia and minimize adverse effects. Optimizing pain management through genotype-guided approaches may ultimately provide safer and more effective therapy for pain control while decreasing the risk for opioid misuse.

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“…Similarly, commercial insurers such as UnitedHealthcare have begun to cover some pharmacogenetic tests. 6 Medicare or Medicaid plans cover some testing panels' costs and patients do not incur any out-of-pocket costs; however, some private insurance companies require patients to pay at least a portion of the cost, and many companies offer financial assistance for patients based on income and other factors. Although financial coverage for testing has improved, patients may still face out-of-pocket costs; therefore, clinicians may need to weigh the benefits of pharmacogenetic testing vs its cost.…”

Section: Consider the Costmentioning

confidence: 99%

“…For example, if a patient has a genotype and/or phenotype that aligns with medication recommendations, the DST might not be able to identify a better medication to use, but may be able to recommend dosing guidance to improve the tolerability of the patient's current therapy. 6 It is also important to understand that the results of such testing may have a broader use beyond the initial reason for obtaining testing, such as when prescribing a common blood thinner such as warfarin or clopidogrel. However, for many of the pharmacodynamic genes that are included in these panels, their use beyond the treatment of depression may be limited because outcome studies for pharmacodynamic pharmacogenes may vary based on psychiatric diagnosis.…”

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confidence: 99%

Pharmacogenetic testing: Navigating through the confusion

Edokobi¹

2021

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Considerations When Applying Pharmacogenomics to Your Practice

Cited by 28 publications

References 82 publications

Development of the pharmacogenomics and genomics literacy framework for pharmacists

Development of the pharmacogenomics and genomics literacy framework for pharmacists

Pharmacogenetics: A precision medicine approach to combatting the opioid epidemic

Pharmacogenetic testing: Navigating through the confusion

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