Abstract
To provide the best available evidence-based care to their patients, advanced practitioners (APs) must become proficient in genomic competencies and remain informed regarding the availability of pharmacogenomic tests. Databases, such as the Centers for Disease Control and Prevention's "Genomic Testing," provide guidance about pharmacogenomic testing, but many APs are not aware of these resources. This study employed a quasi-experimental pretest/posttest design using a convenience sample of APs in a large clinical outpatient breast cancer clinic to assess the knowledge base, beliefs, attitudes, and barriers regarding pharmacogenomic testing among front-line APs and increase knowledge through a targeted educational intervention. The objectives of the educational intervention were to (1) increase knowledge of the clinical indication for testing; (2) increase collaboration among the interprofessional team; and (3) identify correctly when the plan of care should be modified based on pharmacogenomic test results to optimize patient outcomes. Responses showed that these oncology APs possess a strong foundation in genetics and support the addition of new pharmacogenomic tests to their practice.
Highlights
Advanced practitioners (APs), including nurse practitioners (NPs) and physician assistants (PAs), are important members of the interprofessional clinical team caring for patients with cancer
Clinical care is increasingly complex, requiring knowledge of pathophysiology and genomics for everyday practice. This is especially true in the oncology setting, where genetic testing is an important part of standard practice (National Comprehensive Cancer Network [NCCN], 2015a)
Resources such as databases supported by PharmGKB and the US Food and Drug Administration (FDA) are available; they catalogue the body of pharmacogenomic knowledge and rate the level of evidence for pharmacogenomic tests based on the latest information (FDA, 2015; PharmGKB, 2014)
Summary
Design This pilot study used a quasi-experimental pretest/posttest design to assess knowledge about pharmacogenomic testing before and after a targeted educational intervention. The questionnaire was modified based on interviews with a clinical expert (a senior unit AP not participating in the project) regarding barriers to implementation, relevant practice issues, and applicable pharmacogenomic tests. Educational Module The educational module developed for this project focused on four FDA-approved pharmacogenomic tests, chosen for their relevance to an oncology unit–specific practice and offered as drug/gene pairs following the Clinical Pharmacogenetics Implementation Consortium (CPIC) convention (Table 2). The educational intervention provided a brief overview of drug metabolism, genetic variation, and recent advances in genome sequencing. Additional resources, including links to the databases used to develop the intervention, a related module, and an article on ethical considerations of pharmacogenomic testing, were provided. Female 48.2 years 23.2 years 7.8 years MSN, CRNP test questionnaire was administered immediately after the educational intervention, and a followup questionnaire was administered 1 month later
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