Educational strategies to enable expansion of pharmacogenomics-based care

Abstract

Purpose Educational barriers hinder the widespread application of pharmacogenomics in clinical practice. This review summarizes requisite pharmacist competencies, educational standards, and the current state of pharmacogenomics education to propose best practice solutions for educators to meet the specific needs and challenges of this complex topic. Summary Consensus-based pharmacist competencies and clinical guidelines have been published to guide knowledge attainment and application of pharmacogenomics concepts. Pharmacogenomics education is often integrated into existing courses and increasingly, within required standalone courses within PharmD curricula. Continuing education programs and limited postgraduate residencies/fellowship training opportunities are available to practitioners. However, challenges in identifying the optimal structure and amount of coverage, limited number of faculty experts, and inadequate availability of advanced pharmacogenomics practice settings for experiential education are limiting. Fortunately, successful approaches are emerging for both students and practitioners. In pharmacy schools, strategies include early exposure through foundational courses, incorporation into practice-based therapeutics courses, and introductory and advanced pharmacy practice experiences. For practitioners, institution-specific training, online resources, education within clinical decision support tools, and certificate programs can supplement more robust structured post-graduate training programs. Recent data also show the success of shared curricula and participatory education models involving an opportunity for learners to undergo personal genomic testing first-hand. Conclusion The pharmacy profession has taken a leadership role in expanding student and practitioner education to meet the demands of precision medicine initiatives. Effective approaches to attain pharmacogenomics knowledge and to drive its appropriate application in clinical practice are increasingly available.

An Effective Approach to Teaching Pharmacogenomics in the First Year of Pharmacy Curriculum

“…Weitzel and colleagues listed the different factors that affect educational approaches, such as class size and type of curriculum. 30 Educational approaches include didactic lectures, 31 clinical exercises and online resources, 32 personal genomic sequencing, 33 laboratory exercises 34 and bionformatics, 35 flipping content, 36 shortanswer problem solving, 31 medical literature review, 31 experiential activities, 37 and medical evidence review, among others. Some pharmacy schools have tried implementing students' personal genetic sequencing, 33 but this approach could be controversial, 38 and risks failing the four pillars of genetic counseling (autonomy, confidentiality, beneficence, and justice).…”

“…39 In this study, students were exposed to different topics such as patient stratification based on genetic background and involving predicting responders and non-responders, or those with higher or lower risks of developing an adverse effect, discussion of ethical issues and barriers to implementation of genetic testing such as electronic health record or GINA. 8,17,30 Group activities were offered in addition to lectures. All group activities were well received by the students, and were found useful for their learning.…”

Pharmacogenomics: From classroom to practice

“…Pharmacists are expected to advise clinicians on matters related to implementation of pharmacogenomics in patient care (Mccullough et al, 2011;Rao, Mayhew, & Rao, 2015), and to ensure the use of pharmacogenomics testing when appropriate for medication therapy (Haidar et al, 2015;Swen et al, 2008). Furthermore, some pharmacists are also involved in developing prescribing guidelines such as those from the Clinical Pharmacogenetics Implementation Consortium (CPIC; Daly, 2014), as well as in the application of pharmacogenomics principles in practice (El-Ibiary, Cheng, & Alldredge, 2008;Ferreri et al, 2014;Owen, Director, & Practice, 2011;Padgett, O'Connor, Roederer, McLeod, & Ferreri, 2014;Weitzel et al 2016). Despite all the efforts dedicated in the classrooms, the current reality is a little behind of what the students are being trained for.…”

Aligning the AACP Strategic Engagement Agenda with Key Federal Priorities in Health: Report of the 2016-17 Argus Commission

“…One manuscript in the series described the educational implications of pharmacogenomics for the profession. 7 This group of pharmacogenomics leaders also published a commentary in January 2017 in the Journal of the American Pharmacists Association which contained an updated set of pharmacogenomics competencies in pharmacy practice and recommendations related to the preparation of practicing pharmacists and student pharmacists. 8 In their opening paragraph, the authors quote Crews et al in summarizing the logical role for pharmacists in pharmacogenomics: "As a profession, pharmacy has long assumed a valued role in the leadership of therapeutic drug monitoring (eg, pharmacokinetics) and pharmacotherapy services owing to pharmacy's specialized training and an established practice record in medication management.…”