The Pharmacist’s Corner: What roles can pharmacists play in pharmacogenetics?

By Rachel Sass, PharmD

pharmacistWhat is your perception of a pharmacist? Someone in a white coat at the local pharmacy who fills your prescriptions, answers your questions and helps you pick out the right over-the-counter medicine? This is how pharmacists have historically been remembered, and while this area of pharmacy is still critical to the field, the pharmacist’s role has expanded widely.

Thanks to extensive training in pharmacokinetics, pharmacology and therapeutics, pharmacists have the opportunity to play a unique role in interdisciplinary teams and work with physicians, dietitians and other medical professionals to enhance patient care. Pharmacists have already been integrated as critical players in such teams and have even taken the lead in specialty areas, such as anticoagulation, critical care and antibiotic dosing, among many others. These pharmacist-driven programs have become standard of care in many of these specialty areas.

But what about pharmacogenetics?

Clinical pharmacogenomics programs utilizing pharmacogenetic information have been implemented at multiple sites across the country. In a recent article in the journal Pharmacotherapy, Owusu-Obeng et al. discussed the successful implementation of a translational clinical practice initiative using CYP2C19 genotypes to guide clopidogrel therapy.

This pharmacist-led effort in the University of Florida Health Personalized Medicine Program used genetics to tailor antiplatelet therapies for patients undergoing percutaneous coronary intervention and stent placement.  In the first two years of the program, 14 different pharmacists were directly or indirectly involved and were identified by the study authors as being essential to the success of the program.

Additionally, the article identified essential skills that a pharmacist must have prior to initiating a new clinical pharmacogenomics program. These included knowledge about clinical applications of genotype-guided therapy, relevant drug-gene pairs and pharmacogenetic laboratory testing.

“Clinical pharmacists are well positioned to implement clinical pharmacogenomics programs, with expertise in pharmacokinetics, pharmacogenomics, informatics, and patient care,” Owusu-Obeng et al. write.

“Education, training, and practice-based resources are needed to support these roles and to facilitate the development of financially sustainable pharmacist-led clinical pharmacogenomics practice models.”

As a broader understanding of pharmacogenetics gains importance for many healthcare providers, multiple efforts are being made to implement pharmacogenomics in every day practice. Pharmacogenomic competencies are included in pharmacy school accrediting standards, and some professional organizations have adopted professional pharmacogenomics competencies for pharmacists.

Additionally, experts in the field, such as the Clinical Pharmacogenomics Implementation Consortium and the Dutch Pharmacogenetics Working Group, are continuously curating the literature and providing health care providers with clinically actionable guidance.

Pharmacists are well positioned to play a role in implementing pharmacogenetic information. Possible roles include using such information as part of comprehensive medication therapy management programs and involvement in specialty areas that commonly use medications affected by pharmacogenetic variations, such as pain or psychiatry.

These examples represent only a few of the multiple possibilities of how pharmacists can assist with implementation of pharmacogenomics. The American Society of Health System Pharmacists released a statement of the Pharmacist’s Role in Clinical Pharmacogenomics in June of 2014, which provides some additional examples of how pharmacists can implement pharmacogenomics into every day practice. Overall, using pharmacogenetic information has the potential to improve medication-related outcomes and patient safety.

Genelex’s team of highly skilled pharmacists plays a crucial role in helping advance the use of pharmacogenetics to personalize prescribing and medication management through the YouScript Personalized Prescribing System. Learn more about the team here.

Rachel Sass, PharmD, is a board-certified pharmacotherapy specialist who has worked at a Genelex as a personalized prescribing clinical pharmacist for one year.

This is the inaugural post in a guest blogger series PGx in Practice is launching that will feature subject matter experts from within Genelex discussing issues pertaining to pharmacogenetics and the healthcare industry