The Critical Role of Pharmacists in the Clinical Delivery of Pharmacogenetics in the U.S

How equipped are pharmacists for pharmacogenomics?: A cross-sectional study on knowledge, attitudes, and implementation practices in Saudi Arabia

Pharmacogenomics, the study of genetic influences on drug response, advances personalized medicine by tailoring therapy to individual genetic profiles, reducing adverse effects and optimizing efficacy. Pharmacists, as accessible healthcare providers, are well-positioned to facilitate the integration of pharmacogenomics into clinical practice. This study assesses Saudi pharmacists' knowledge, attitudes, and practices regarding pharmacogenomics and identifies key barriers and facilitators affecting their readiness. A cross-sectional survey was conducted between July and October 2024 among 426 licensed pharmacists across various practice settings in Saudi Arabia: a validated, structured questionnaire assessed demographics, pharmacogenomics knowledge, attitudes, and implementation practices. Snowball sampling facilitated participant recruitment. Descriptive statistics summarized the findings, and Chi-square tests were applied to examine associations between socio-demographic variables and pharmacogenomics-related responses. Among 426 participants, while most pharmacists recognized the value of pharmacogenomics, knowledge gaps were notable, particularly in interpreting genetic tests and applying clinical recommendations. Only 52.3% received pharmacogenomics training, mainly through university courses, and 40.6% had never consulted pharmacogenomics resources in practice. Key barriers included limited access to genetic testing (74.2%) and lack of reimbursement (64.5%). Socio-demographics, such as age and practice setting, significantly impacted knowledge and attitudes. Saudi pharmacists face considerable barriers to pharmacogenomics readiness, including knowledge gaps, limited access to genetic testing, and insufficient institutional support. Addressing these challenges requires targeted education, structured policy initiatives, and enhanced resource availability to facilitate the effective integration of pharmacogenomics into pharmacy practice. Strengthening pharmacists' competencies in this field will be essential to optimizing patient care and advancing precision medicine in Saudi Arabia.

Integrating pharmacogenomics in three Middle Eastern countries' healthcare (Lebanon, Qatar, and Saudi Arabia): Current insights, challenges, and strategic directions

BACKGROUND AND OBJECTIVES

Pharmacogenomics (PGx) leverages genomic information to tailor drug therapies, enhancing precision medicine. Despite global advancements, its implementation in Lebanon, Qatar, and Saudi Arabia faces unique challenges in clinical integration. This study aimed to investigate PGx attitudes, knowledge implementation, associated challenges, forecast future educational needs, and compare findings across the three countries.

METHODS

This cross-sectional study utilized an anonymous, self-administered online survey distributed to healthcare professionals, academics, and clinicians in Lebanon, Qatar, and Saudi Arabia. The survey comprised 18 questions to assess participants' familiarity with PGx, current implementation practices, perceived obstacles, potential integration strategies, and future educational needs.

RESULTS

The survey yielded 337 responses from healthcare professionals across the three countries. Data revealed significant variations in PGx familiarity and educational involvement. Qatar and Saudi Arabia participants were more familiar with PGx compared to Lebanon (83%, 75%, and 67%, respectively). Participation in PGx-related talks was most prevalent in Saudi Arabia (96%), followed by Qatar (53%) and Lebanon (35%). Key challenges identified included test cost and reimbursement, insufficient physician knowledge, and lack of infrastructure. Lebanon reported the highest concern for test costs (16%), compared to the lowest in Saudi Arabia (5%). Despite these challenges, a strong consensus emerged on PGx's potential to improve patient outcomes, with over 86% of respondents in all three countries expressing this belief. Educational interest areas varied by country, with strong interest in PGx for cancer chemotherapy in Saudi Arabia and Lebanon and for diabetes mellitus in Qatar.

CONCLUSION

This study highlights the significant influence of varied educational backgrounds and infrastructural limitations on PGx implementation across Lebanon, Qatar, and Saudi Arabia. The findings emphasize the need for targeted strategies in each country to address these distinct barriers. Integrating PGx education into healthcare training programs and clinical workflows could unlock PGx's potential to optimize patient care.

Exploring the Clinical Workflow in Pharmacogenomics Clinics: An Observational Study

Background: Pharmacogenomics (PGx) is the future of healthcare and implementation is being driven by increasing evidence. Understanding the workflow in a PGx clinic provides insight into the development and implementation of PGx services. It considers the patient's perspective, the role of the interprofessional team and the pivotal input of the pharmacist. Objectives: The purpose of this study was to describe the clinical workflow followed in selected PGx clinics. Methods: Four different sites that offer PGx clinical services (United States of America) were included. Qualitative data were collected through semi-structured interviews and observations providing valuable insights into the workflow followed in both community-based and hospital-based PGx clinics. Results: Although each setting differed, the processes were similar with setting-specific workflows and barriers. This study highlights the role of the pharmacist and the interprofessional team, the resources used for interpretation of PGx test results and the importance of patient and healthcare education. Conclusions: Understanding the workflow and the role of the interprofessional team in PGx is essential to ensure successful implementation and sustainable precision medicine practices in resource-limited settings.

Enhancing Rural Healthcare Accessibility: A Model for Pharmacogenomics Adoption via an Outreach-Focused Integration Strategy

Background/Objectives: Pharmacogenomics is an emerging field in precision medicine that aims to improve patient outcomes by tailoring drug selection and dosage to an individual's genetic makeup. However, patients in rural communities often cannot take advantage of specialized services such as pharmacogenomics due to various barriers that limit access to healthcare. This article aims to identify the barriers to implementing pharmacogenomic initiatives in rural communities and assess strategies for integrating pharmacogenomics into rural healthcare systems. Methods: This article describes the qualitative research that was conducted using semi-structured interviews with various stakeholders in addition to explaining how strategic frameworks were used to synthesize secondary research. Results: The findings of this article indicated mixed awareness of pharmacogenomics as an option amongst stakeholders, highlighting the need for targeted outreach and education intervention. Solutions such as mail-in testing and telemedicine were determined to be feasible solutions to address various geographical and logistical barriers that exist for rural patients. This article determines that successful strategies will leverage existing infrastructure and prioritize patient care, workflow integration, and adoption. Conclusions: Making pharmacogenomics a viable option for rural patients will take a multi-faceted approach that combines outreach, education, and innovative delivery models to overcome the multiple barriers facing rural communities.

Trends in and predictors of patient pharmacogenomic test uptake in a national health care system

PURPOSE

Better understanding patient uptake of pharmacogenomic (PGx) testing may inform its implementation and maximize the benefits that such testing can confer. This study examined patient and provider factors associated with PGx test ordering in a national health care system in which panel-based testing was implemented as part of routine care.

METHODS

We used a retrospective matched cohort design and data from the Veterans Health Administration Corporate Data Warehouse. A conditional logistic model was used to identify factors associated with a PGx order receipt and estimate odds ratios and 95% confidence intervals.

RESULTS

The following patient factors predicted receipt of a PGx test order: younger age, married status, rural residence, non-Hispanic Black or Hispanic race/ethnicity, PGx educational mailer receipt, depression diagnosis, allergy to a drug on the panel, prescriptions for drugs on the panel, and specialty care visits (P < .05). Additionally, patients whose providers were female, younger, a nurse practitioner/physician assistant or pharmacist, or participated in an educational mailer program were more likely to receive an order (P < .05).

CONCLUSION

This study highlights factors that may facilitate or hinder the widespread and equitable implementation of PGx testing in a large national health care system. The information is being used to further refine the program.

Discussion on the optimization of personalized medication using information systems based on pharmacogenomics: an example using colorectal cancer

Pharmacogenomics (PGx) is a powerful tool for clinical optimization of drug efficacy and safety. However, due to many factors affecting drugs in the real world, PGx still accounts for a small proportion of actual clinical application scenarios. Therefore, based on the information software, pharmacists use their professional advantages to integrate PGx into all aspects of pharmaceutical care, which is conducive to promoting the development of personalized medicine. In this paper, the establishment of an information software platform is summarized for the optimization of a personalized medication program based on PGx. Taking colorectal cancers (CRC) as an example, this paper also discusses the role of PGx in different working modes and participation in drug management of CRC patients by pharmacists with the help of information systems. Finally, we summarized the recommendations of different PGx guidelines to provide reference for the follow-up personalized pharmaceutical care.

Understanding general practitioner and pharmacist preferences for pharmacogenetic testing in primary care: a discrete choice experiment

Pharmacogenetic testing in the United Kingdom's National Health Service (NHS) has historically been reactive in nature, undertaken in the context of single gene-drug relationships in specialist settings. Using a discrete choice experiment we aimed to identify healthcare professional preferences for development of a pharmacogenetic testing service in primary care in the NHS. Respondents, representing two professions groups (general practitioners or pharmacists), completed one of two survey versions, asking them to select their preferred pharmacogenetic testing service in the context of a presentation of low mood or joint pain. Responses from 235 individuals were included. All respondents preferred pharmacogenetic testing over no testing, though preference heterogeneity was identified. Both professional groups, but especially GPs, were highly sensitive to service design, with uptake varying depending on the service offered. This study demonstrates uptake of a pharmacogenetic testing service is impacted by service design and highlights key areas which should be prioritised within future initiatives.

Knowledge and perceptions of pharmacogenomics among pharmacists in Manitoba, Canada

Objective: This work was designed to describe the knowledge and perceptions of pharmacogenomics (PGx) among pharmacists in the Canadian province of Manitoba. Methods: A 40-item, web-based survey was distributed to pharmacists in Manitoba. Results: Of 74 participants, one third had some education or training in PGx, and 12.2% had used PGx test results in their practice. Participants' self-rated knowledge of PGx testing and common PGx resources (e.g., Pharmacogenomics Knowledge Base, Clinical Pharmacogenetics Implementation Consortium) was low. Most pharmacists surveyed believe that PGx can improve medication efficacy (82.4%) or prevent adverse drug reactions (81.1%). Most (91%) desired more education on PGx. Conclusion: Manitoba pharmacists reported positive perceptions toward PGx. However, they are currently underprepared to implement PGx into practice.

The Potential Roles of Pharmacists in the Clinical Implementation of Pharmacogenomics

The field of pharmacogenomics is at the forefront of a healthcare revolution, promising to usher in a new era of precision medicine [...].