Pharmacogenomics Enhances Medication Management in Pharmacy Practice

Pharmacogenomics (PGx) testing is feasible and improves medication outcomes in pharmacy practice, according to a scoping review of 43 studies published in Research in Social and Administrative Pharmacy.

“There has been significant and exponential growth in research applying PGx testing to medication therapy management (MTM) and clinical services provided by pharmacists through the last decade,” wrote researchers from the University of Alberta Faculty of Pharmacy and Pharmaceutical Sciences, Edmonton, Alberta, Canada. “Research occurs in a variety of practice settings, with almost a quarter of studies to date in the community pharmacy.”

The 43 studies investigating the use of PGx by pharmacists in the review were published between 2007 and 2020. Researchers were interested in non-oncologic pharmacy practices incorporating PGx testing and how they benefit patient outcomes.

The most studied practice model, which occurred in both community and institutional settings, was CYP2C19 testing with antiplatelets, according to the study.

“It also was the most actionable test: approximately 30% of patients have polymorphisms indicating a need for alternative antiplatelets,” researchers wrote, “and identifying these patients can reduce morbidity and mortality by more than 50%.”

Broader, multigene panel tests used in MTM have halved the number of emergency visits and hospitalizations among older adults with polypharmacy in studies, researchers reported. PGX has also shown benefit for cardiovascular, psychiatric, analgesic, and gastrointestinal indications. Pharmacist education on PGx, collaboration with other health care providers, and the use of clinical decision software were identified as facilitators for PGx implementation success.

Studies have yet to report on actual costs, however, or pharmacist prescribing within pharmacy-based PGx.

“Further PGx research should be directed towards pharmacist prescribing, pharmacist education, and pharmacoeconomics,” researchers advised.

Reference: 
Hayashi M, Hamdy DA, Mahmoud SH. Applications for pharmacogenomics in pharmacy practice: A scoping review. Res Social Adm Pharm. 2022;18(7):3094-3118. doi: 10.1016/j.sapharm.2021.08.009