Applications for pharmacogenomics in pharmacy practice: A scoping review

Area of Science:

• Pharmacogenomics
• Pharmacy Practice
• Clinical Pharmacy

Background:

• Pharmacogenomics (PGx) offers valuable drug therapy insights for pharmacists, particularly in medication therapy management (MTM).
• A comprehensive understanding of PGx use in pharmacy practice-based research is lacking.
• Identifying optimal populations and settings for PGx implementation is crucial for future research, practice, and policy.

Purpose of the Study:

• To conduct a scoping review identifying evidence of pharmacogenomic testing use in non-oncologic pharmacy practice.
• To summarize patient characteristics, pharmacy settings, genetic tests, and outcomes to identify beneficial PGx models.

Main Methods:

• A scoping review methodology was employed.
• Searches were conducted across 5 databases and relevant journals for studies on PGx in pharmacy practice.
• Data extraction focused on patient and setting characteristics, genetic tests, and clinical outcomes.

Main Results:

• 43 studies (2007-2020) documented pharmacist use of PGx.
• CYP2C19 testing for antiplatelet therapy was the most studied, with ~30% of patients requiring alternative treatments, reducing morbidity/mortality by >50%.
• Multi-gene panels in MTM for elderly polypharmacy patients reduced emergency visits/hospitalizations by ~50%; benefits also noted in cardiovascular, psychiatric, analgesic, and GI indications.

Conclusions:

• Pharmacogenomic testing is feasible and improves medication outcomes in pharmacy settings, including community pharmacies.
• Future research should prioritize pharmacist prescribing, comprehensive pharmacist education on PGx, and pharmacoeconomic evaluations.
• Facilitators for successful PGx integration include pharmacist training, interprofessional collaboration, and clinical decision support software.