Interprofessional Education for Personalized Medicine Through Technology-Based Learning

Haga, Susanne B.; Mills, Rachel; Aucoin, Julia; Taekman, Jeff

doi:10.2217/pme.14.91

Cited by 5 publications

(4 citation statements)

References 64 publications

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“…The implementation of pharmacogenetics has grown in various healthcare settings, because of advancements in technology, accumulation of evidence of genetic associations with drug response, and increased provider and pharmacist training [ 1 , 2 , 3 , 4 , 5 , 6 ]. The field of pharmacogenetics focuses on the impact of interindividual variability in drug response due to genetic variation and the usage of this information to guide drug therapy decisions; pharmacogenetic test results can be utilized as another tool to individualize drug therapy, similar to monitoring serum creatinine levels or drug interactions [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Design and Early Implementation Successes and Challenges of a Pharmacogenetics Consult Clinic

Arwood

Dietrich

Duong

et al. 2020

JCM

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Pharmacogenetic testing (PGT) is increasingly being used as a tool to guide clinical decisions. This article describes the development of an outpatient, pharmacist-led, pharmacogenetics consult clinic within internal medicine, its workflow, and early results, along with successes and challenges. A pharmacogenetics-trained pharmacist encouraged primary care physicians (PCPs) to refer patients who were experiencing side effects/ineffectiveness from certain antidepressants, opioids, and/or proton pump inhibitors. In clinic, the pharmacist confirmed the need for and ordered CYP2C19 and/or CYP2D6 testing, provided evidence-based pharmacogenetic recommendations to PCPs, and educated PCPs and patients on the results. Operational and clinical metrics were analyzed. In two years, 91 referred patients were seen in clinic (mean age 57, 67% women, 91% European-American). Of patients who received PGT, 77% had at least one CYP2C19 and/or CYP2D6 phenotype that would make conventional prescribing unfavorable. Recommendations suggested that physicians change a medication/dose for 59% of patients; excluding two patients lost to follow-up, 87% of recommendations were accepted. Challenges included PGT reimbursement and referral maintenance. High frequency of actionable results suggests physician education on who to refer was successful and illustrates the potential to reduce trial-and-error prescribing. High recommendation acceptance rate demonstrates the pharmacist’s effectiveness in providing genotype-guided recommendations, emphasizing a successful pharmacist–physician collaboration.

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Section: Introductionmentioning

confidence: 99%

Design and Early Implementation Successes and Challenges of a Pharmacogenetics Consult Clinic

Arwood

Dietrich

Duong

et al. 2020

JCM

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“…Interprofessional learning was discussed as the preferred approach, with implications for content; ‘as participants have to work together, so why not learn together ’. Consistent with findings in the literature, practical implementation relies on interprofessional education that will support communication across settings in a robust integrated care delivery [ 61 ]. Implementation of a training programme in PM that is fit for purpose for each professional group presents inherent challenges to design.…”

Section: Discussionmentioning

confidence: 64%

“…Extrinsic motivating factors in this study were reported as when PM enters into clinical guidelines, safe management of patient data across settings and the need to change insurance models, as examples. Targeted clinical guidelines based on efficacy and effectiveness of PM in practice can provide one of the keys to unlocking successful implementation of a precision approach to patient care [ 61 ]. From these findings we deduce that attendance, as a critical success factor, is driven by motivation.…”

Section: Discussionmentioning

confidence: 99%

Investigating acceptability of a training programme in precision medicine for frontline healthcare professionals: a mixed methods study

et al. 2022

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Background Precision Medicine offers tailored prevention, diagnosis, treatment and management to patients that considers genomics, lifestyle and environmental factors. If implementation of Precision Medicine is to advance, effective, focused upskilling of frontline healthcare professionals through quality continuing professional development is needed. This study reports on an evidence-based approach to needs assessment to investigate the current level of knowledge of Precision Medicine, acceptable content for training, the perceived potential of a more precision approach to patient care and motivation to participate in a training programme among pharmacists, advanced practice nurses and general practitioners. Investigating perceived needs can avoid a top-down approach and support a design that is fit for purpose to targeted professions. Methods This study reports on 2 focus groups (n = 12) delivered in French and German with equal professional participation of the targeted professions. The research objectives were investigated in two phases. During the first phase, a literature review and expert consultations were conducted to develop a definition of PM, patient cases and content for training. In a second phase, these investigations were further explored using focus groups to investigate acceptable learning objectives, the potential of PM to relevant professions and motivation of participants. Quantitative investigations using rating scales and visual analogues were incorporated. The focus groups were audio recorded, transcribed by intelligent verbatim and translated to English. NVivo was used for data analysis and interpretation following a hybrid approach using the Framework Method and thematic analysis. The analytical framework, Implementation Science, was applied to organise and present research data. Results Precision Medicine is considered a new topic area, largely unfamiliar to frontline healthcare professionals.. There was acceptance of a more precision approach to care among all participants with perceived positive implications for patients. Valuable insight was gathered on acceptable content and form for training. All participants expressed concerns on readiness within their professions which included an insufficient system infrastructure, a lack of time to attend needed training, a lack of clarity for use in practice and the time needed to build a support network. Conclusions A precision approach to patient care is on the horizon for health care professionals not only in hospital settings but also at the community level. Our results conclude that an adaptable and flexible training programme in PM is timely, contextually relevant and conducive to the needs of targeted health professions for successful implementation. A training programme in PM will require support across sectors and stakeholders, supporting insurance models, educated patients and integrated care supported by innovative technology. Implementation Science outcomes are a useful strategy towards design of an effective training programme that can have measurable impact in practice.

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“…This can be the optimal result to achieve when different medical care roles will collaborate and communicate correctly with each other. This way, healthcare services can work together with patients to address all issues in a cohesive manner (Haga et al 2015), moving to a co-diagnosis and a co-care model between physicians, patients, and other parties.…”

Section: Communication Through Ehealthmentioning

confidence: 99%

P5 eHealth: An Agenda for the Health Technologies of the Future

Pravettoni¹,

Triberti²

2020

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Interprofessional Education for Personalized Medicine Through Technology-Based Learning

Cited by 5 publications

References 64 publications

Design and Early Implementation Successes and Challenges of a Pharmacogenetics Consult Clinic

Design and Early Implementation Successes and Challenges of a Pharmacogenetics Consult Clinic

Investigating acceptability of a training programme in precision medicine for frontline healthcare professionals: a mixed methods study

P5 eHealth: An Agenda for the Health Technologies of the Future

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