Pharmacogenomic testing and its future in community pharmacy

Abstract

Although it is common to see pharmacogenomic testing used North America and Australia, it is not yet part of practice in the UK. With the promise of genomic screening becoming part of the NHS, pharmacists must equip themselves with a knowledge of how the process works. Source: Shutterstock.com In January 2019, the UK government unveiled its ten-year plan for NHS England and emphasised the role pharmacists can play in promoting patient self-care [1]. There was also a focus on delivering value from medicines and reducing avoidable medicines related-harm, which costs the NHS a minimum of £98.5m per year [2]. This coincides with the NHS Genomic Medicine Service, which will be rolled out across England from April 2020, meaning that the routine use of genomic screening and personalised treatments will be the new normal in the NHS [3],[4]. Pharmacists' advice currently relies on knowledge of observable patient characteristics, such as age, weight, comorbidities and concurrent medicines, while largely disregarding genetics. However, it is estimated that genetic factors could contribute to between 25-50% of inappropriate drug responses [5]. Knowing exactly which medicine to use for a patient and which to avoid can be a challenging task in clinical practice. However, pharmacogenomics can provide the prescriber with additional information on some of the unobserved patient characteristics that affect drug responsethis can assist with both drug selection and safety. Therefore, the combination of this pharmacogenomic information along with other factors influencing pharmaceutical care may provide an opportunity to deliver more 'personalised' medicine, facilitating better selection and reducing the need for 'trial and error' prescribing.