Independent Community Pharmacists’ Experience in Offering Pharmacogenetic Testing

Abstract

This study assessed pharmacist experiences with delivering pharmacogenetic (PGx) testing in independent community pharmacies. Methods: We conducted a cluster randomized trial of independent community pharmacies in North Carolina randomized to provide either PGx testing as a standalone service or integrated into medication therapy management (MTM) services. Surveys and pharmacist data about the delivery of PGx testing were collected. Semi-structured interviews were also conducted. Results: A total of 36 pharmacists participated in the study from 22 pharmacies. Sixteen pharmacists completed the pre-study and post-study surveys, and four pharmacists completed the semi-structured interviews. Thirty-one percent (11/36) of pharmacists had had some education in personalized medicine or PGx prior to the study. The only outcome that differed by study arm was the use of educational resources, with significantly higher utilization in the PGx testing only arm (p=0.007). Overall, compared to the pre-study assessment, pharmacists' knowledge about PGx significantly improved post-study (p=0.018). In the post-study survey, almost all pharmacists indicated that they felt qualified/able to provide PGx testing at their pharmacy. While 75% of pharmacists indicated that they may continue to provide PGx testing at their pharmacy after the study, the major concerns were lack of reimbursement for PGx counseling and consultation given the necessary time required. Conclusion:Our findings demonstrated a positive experience with delivering PGx testing in the community pharmacy setting with little difference in pharmacists' experiences in providing PGx testing with or without MTM. Pharmacists were confident in their ability to provide PGx testing and were interested in continuing to offer testing, though sustained delivery may be challenged by lack of prescribing provider engagement and reimbursement.

Nation-Wide Survey Assessing the Knowledge and Attitudes of Romanian Pharmacists Concerning Pharmacogenetics

“…Most pharmacists knew that PGx studies the influence of genetic variability over efficacy and safety of drugs. Similar results were observed in other studies performed in high-income countries (Haga et al, 2021), but in middle-and low-income countries pharmacists' knowledge concerning PGx was lower, with fewer professionals being familiar with this field (Nagy et al, 2020;Albitar and Alchamat, 2021;Mufwambi et al, 2021). However, when asked more specific questions, Romanian pharmacists displayed lower knowledge, not being aware of the mechanisms behind drug-response variability or regarding the influence of genetic variability over the efficacy and safety of drugs such as clopidogrel, codeine or carbamazepine.…”

“…It is also possible that pharmacists also see this activity as a supplemental task in an already very demanding profession. This aspect has been evaluated in other studies showing that busy community pharmacies may not be able to provide in-depth PGx counseling due to the additional time requirements (Haga et al, 2021). However, this activity should be taken into consideration by pharmacies; direct-toconsumer PGx testing may also significantly increase the role of pharmacists as patients may consult with them to better understand their test results and how it impacts their current medication (Haga et al, 2021).…”

“…This aspect has been evaluated in other studies showing that busy community pharmacies may not be able to provide in-depth PGx counseling due to the additional time requirements (Haga et al, 2021). However, this activity should be taken into consideration by pharmacies; direct-toconsumer PGx testing may also significantly increase the role of pharmacists as patients may consult with them to better understand their test results and how it impacts their current medication (Haga et al, 2021). Pharmacists can play a substantial role in identifying eligible patients, providing patient counseling before and after testing, sample collection and shipment, results interpretation, and communication with prescribers (Haga et al, 2021).…”

“…However, this activity should be taken into consideration by pharmacies; direct-toconsumer PGx testing may also significantly increase the role of pharmacists as patients may consult with them to better understand their test results and how it impacts their current medication (Haga et al, 2021). Pharmacists can play a substantial role in identifying eligible patients, providing patient counseling before and after testing, sample collection and shipment, results interpretation, and communication with prescribers (Haga et al, 2021). Nevertheless, in our study, a fairly small number of respondents (16.6%) stated that they have been asked questions regarding PGx by their patients.…”

Real-World Impact of a Pharmacogenomics-Enriched Comprehensive Medication Management Program

“…Pharmacogenomics (PGx) has been shown to play an important role in certain prescribing situations by identifying medication responders and non-responders to avoid specific adverse events and optimize drug dose [ 1 , 2 ]. Indeed, outcome-oriented studies repeatedly demonstrate positive impacts of PGx on individuals [ 3 , 4 , 5 ], providers [ 6 , 7 ], and the healthcare system [ 8 , 9 ]. Oncology [ 10 , 11 ] and psychiatry [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ] implementations demonstrate particularly well-documented improvements.…”