<p>Pharmacogenomic Testing In Pediatrics: Navigating The Ethical, Social, And Legal Challenges</p>

Abstract

For the past several years, the implementation of pharmacogenetic (PGx) testing has become widespread in several centers and clinical practice settings. PGx testing may be ordered at the point-of-care when treatment is needed or in advance of treatment for future use. The potential benefits of PGx testing are not limited to adult patients, as children are increasingly using medications more often and at earlier ages. This review provides some background on the use of PGx testing in children as well as mothers (prenatally and post-natally) and discusses the challenges, benefits, and the ethical, legal, and social implications of providing PGx testing to children.

Exploring NICU nurses' views of a novel genetic point‐of‐care test identifying neonates at risk of antibiotic‐induced ototoxicity: A qualitative study

“…Furthermore, visual aids distributed throughout the unit were also highlighted as a useful training tool. Visual step‐by‐step guides have been discussed in the literature as a facilitator for assisting implementation of a new POCT (Jones et al., 2016) and Haga (2019) highlighted that utilizing multiple modes of information delivery and continuous education is important to increase providers' knowledge of POC testing. Staff interviewed spoke positively of the ‘hands on’ nature of the initial training they received.…”

Implementing Pharmacogenomics Testing: Single Center Experience at Arkansas Children’s Hospital

“…An extensive review of ongoing clinical pharmacogenomics implementation programs at various hospitals and institutions highlighted several adoption and implementation barriers for us to overcome, including scientific, information technology (IT), lack of education of clinical staff and patients, test reimbursement, PGx clinical decision support (CDS), lack of clinician adoption, and data storage for clinical research [ 12 , 39 , 40 , 41 , 42 ].…”

Translational Pharmacogenomics Augmenting Pharmacotherapy

“…The short-and long-term benefits of PGx testing in children, especially with increasing evidence and a decrease in costs for multiple gene testing technologies, should influence a positive attitude toward uptake and user testing. However, for clinical utility, more pediatric trials need to be conducted to understand the impact of drug response in children, who at that young age still do not have a stable expression for several genes related to drug metabolism and transport [62].…”

“…Consequently, a gynecologist can take the assistance of PGx during gestation for medication prescription [63]. A few biomarkers that are PGx liabilities during pregnancy include G6PD, CYP2C19, CYP2D6, and HLA, among others [62,63]. The use of thiopurine drugs, such as azathioprine and 6mercaptopurine, by the mother for the treatment of inflammatory bowel disease (IBD) may provide a little danger to the fetus; however, PGx test can evaluate the amount of risk [64].…”