Expanding pharmacogenomics in the community pharmacy setting: A survey of Alabama community pharmacists' confidence,...

Pharmacogenomics (PGx) clinical decision support (CDS) is essential for effective PGx implementation, yet most tools remain confined to institutional settings. Community pharmacists, who make up nearly half of the U.S. pharmacy workforce, are among the most accessible health care providers, offering care without appointments and reaching patients across both urban and rural areas. This accessibility positions them as critical entry points for delivering PGx services and advancing equitable access. However, many lack the training and resources necessary to provide informed PGx care.

The purpose of this study was to survey Alabama community pharmacists to assess confidence in PGx knowledge and experiences, perceived benefits and barriers, and interest and preparedness for implementation, with attention to the role of CDS tools.

A cross-sectional survey was distributed via email to Alabama pharmacists between September and October 2024. Items included Likert-type scales, multiple-choice, yes/no, and open responses. Descriptive statistics characterized responses, and Mann-Whitney U tests compared responses between subgroups.

Of 1638 invited pharmacists, 233 responded (14.2%), with 135 included in the analysis. Participants were primarily female (70.9%), urban (81.5%), and averaged 45.4 years of age. Only 19% reported prior PGx training. Confidence in foundational knowledge was low (mean scale score = 2.74, standard deviation [SD] = 0.44). Perceived benefits were high (mean scale score = 4.06, SD = 0.17). Interest and preparedness varied (interest = 3.52 [SD = 0.15]; preparedness = 2.69 [SD = 0.32]). Fifty percent desired PGx-CDS tools, and 53% expressed interest in offering PGx services; however, few reported adequate site resources.

Alabama pharmacists expressed strong PGx interest and perceived benefits, but reported gaps in knowledge, confidence, and infrastructure. Given their accessibility, community pharmacists represent a critical bridge to equitable PGx adoption. Expanding PGx education, training, and CDS integration is essential to enable sustainable PGx delivery in community pharmacy.