The Role of the Pediatric Pharmacist in Precision Medicine and Clinical Pharmacogenomics for Children

For years, pharmacogenomics (PGx) has been transitioning from the laboratory to patient care. Utilization of PGx data in patient care is greater than ever, with over 80 institutions in the United States offering PGx services, including at least 12 in pediatric patient populations. There are over 300 drug products with PGx information in their labeling; many of which are commonly used in pediatric populations. Additionally, the increased use of next-generation sequencing (NGS) has led to increased availability of PGx data. Because PGx testing can provide patient-specific predictors for drug response, pharmacists are well positioned to assume a leadership role in PGx testing, clinical interpretation of results, and recommendations for individualization of drug therapy. Opportunities for pharmacists exist in both inpatient and outpatient settings, such as pharmacist-managed clinical PGx consultation services and educating patients about PGx testing. Given the potential for genetic and age-dependent factors to influence drug selection and dosing, pediatric pharmacists should be involved in the development of dosing recommendations and interprofessional practice guidelines regarding PGx testing in pediatric patients. Opportunities to become knowledgeable and competent in PGx extend from coursework as part of the pharmacy curriculum to postgraduate education (e.g., residencies, fellowship, continuing education). The Pediatric Pharmacy Association (PPA) acknowledges a need for pediatric pharmacists to have a working knowledge of PGx and recognizes the importance of PGx education for both students and practicing pharmacists with consideration for infants and children. This group also supports the need to have a subset of pharmacists specially trained in PGx with a pediatric focus.