Abstract
Community pharmacy services have evolved to include medical and pharmaceutical interventions alongside dispensing. While established pharmacogenomic (PGx) testing is available throughout the Netherlands, this is primarily based in hospital environments and for specialist medicines. The aim of this work was to describe how best to implement PGx services within community pharmacy, considering potential barriers and enablers to service delivery and how to address them. The service was implemented across a selection of community pharmacies in the Netherlands. Data were captured on test outcomes and through a pharmacist survey. Following testing, 17.8% of the clinical samples were recommended to avoid certain medication (based on their current medicines use), and 14.0% to have their dose adjusted. Pre-emptive analysis of genotyped patients showed that the majority (99.2%) had actionable variants. Pharmacists felt confident in their operational knowledge to deliver the service, but less so in applying that knowledge. Delivering the service was believed to improve relationships with other healthcare professionals. These results add to the evidence in understanding how PGx can be delivered effectively within the community pharmacy environment. Training pharmacists in how to respond to patient queries and make clinical recommendations may enhance service provision further.
Highlights
The use of pharmacogenomics (PGx) to support a personalized medicines approach can help improve patient safety and lead to better outcomes for patients
Within the Netherlands, a recent estimation of the impact of pre-emptive PGx testing of a panel of 45 drugs indicated that 23.6% of all new prescriptions were linked to an actionable gene–drug interaction (GDI) [2]
The potential to use PGx testing to tailor medicines usage is a natural fit for community pharmacy, where medicines optimization is a key offering of pharmacists through services such as the New Medicines Service in the United Kingdom (UK) [3]
Summary
The use of pharmacogenomics (PGx) to support a personalized medicines approach can help improve patient safety and lead to better outcomes for patients. Most medicines prescribed in primary care may not be considered high risk, the overall prescription volumes of those that are, in combination with high frequency of actionable phenotypes, results in a high potential global impact. Within the Netherlands, a recent estimation of the impact of pre-emptive PGx testing of a panel of 45 drugs indicated that 23.6% of all new prescriptions were linked to an actionable gene–drug interaction (GDI) [2]. The potential to use PGx testing to tailor medicines usage is a natural fit for community pharmacy, where medicines optimization is a key offering of pharmacists through services such as the New Medicines Service in the United Kingdom (UK) [3]
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