A survey on the perspectives of Irish pharmacists on the implementation of pharmacogenetics into pharmacy practice

Abstract

Abstract Introduction Pharmacogenetics is the use of an individual’s genetic data to determine their response to a drug.[1] The incorporation of pharmacogenetic information into the prescribing process has the potential to improve patient outcomes by reducing adverse drug reactions and non-response to drugs.[1] Aim This study aims to evaluate the potential to implement pharmacogenetic testing and counselling into pharmacy practice in Ireland, by looking at the opinions of registered pharmacists on the potential new service. Methods A web-based survey, adapted from a previous survey,[2] was sent out to 6,236 pharmacists on the Pharmaceutical Society of Ireland’s mailing list using the software ‘Limesurvey’ in September 2019. Information was collected anonymously on demographics, knowledge, confidence, attitudes toward pharmacogenetic testing, and barriers and facilitators of pharmacogenetic testing. Quantitative analysis was undertaken using SPSS version 26, including descriptive analysis, correlations (Spearman’s Rho) and comparison of means (ANOVA). Knowledge scores were derived (number of correct questions out of 5), and converted to percentages. Responses to the open-ended question were analysed for recurring themes using qualitative content analysis. Results A response rate of 7.8% was attained with 486 analysable responses, 446 of which were full responses. Responses were submitted by 2.5 times more females than males and the majority came from pharmacists practising in community (56.4%) or hospital (25.3%). There was also a diversity of roles, ages and levels of experience represented. The mean knowledge score was 2.71 out of 5 (54.3%). However, the knowledge score of younger participants was significantly greater than those in the 61+ age bracket (p=0.007), with mean knowledge scores of 58% (20-30 years), 48% (41-50 years) and 40% (61+ years). A majority of respondents (60%) disagreed that their pharmacy education had prepared them sufficiently to counsel on pharmacogenetics. There was a significant relationship between a participant’s knowledge score and their self-reported confidence to discuss pharmacogenetics with other healthcare professionals (p<0.001). Many participants (>80%) agreed that pharmacogenetic testing had potential benefits for patient care. The open-ended question was answered by 17.4% of respondents. Barriers to introducing pharmacogenetic testing into pharmacy practice included ethical issues such as unauthorised access to private data and discrimination by insurance companies. A lack of resources including time and reimbursement were also noted as potential obstacles. Facilitators included an overall positive attitude towards the idea of pharmacogenetic testing. Conclusion Pharmacists already play an important role in medication management and health services. Given their knowledge and experience in the area, pharmacists are ideal candidates to introduce the idea of pharmacogenetic-guided prescribing into routine practice. From this study, it is apparent that for this implementation to occur, further education and training needs to be provided to pharmacists, as well as greater resources. While this study had the limitation of a low response rate, it was the first survey in Ireland to gather the perspectives of pharmacists on implementing pharmacogenetics in Ireland. As the survey was sent to all registered pharmacists, pharmacists from diverse settings and with varied years and types of experience answered this survey.