Decoding pharmacogenomic test interpretation and application to patient care

IF 1.3 Q4 PHARMACOLOGY & PHARMACY Journal of the American College of Clinical Pharmacy : JACCP Pub Date : 2024-05-08 DOI:10.1002/jac5.1958
Roseann S. Donnelly Pharm.D., FCCP, Larisa H. Cavallari Pharm.D., FCCP, Jeannine S. McCune Pharm.D., Ph.D., FCCP, Jennifer Trofe-Clark Pharm.D., FCCP, Christine M. Formea Pharm.D., Glenda Hoffecker Pharm.D., Molly M. Csere BSPharm, Keri C. Anderson Pharm.D., Shubha Bhat Pharm.D., M.S., FCCP, Scott A. Mosley Pharm.D., Qing Ma Pharm.D., Ph.D., Ariel Ferdock Pharm.D., James M. Hoffman Pharm.D., M.S., J. Kevin Hicks Pharm.D., Ph.D., FCCP, Kelly E. Caudle Pharm.D., Ph.D., FCCP
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Abstract

Pharmacogenomics is a growing area of medicine, and pharmacists across clinical practice settings have the opportunity to individualize medication selection and dosing using genetic data. However, many practicing pharmacists may feel ill-equipped to interpret pharmacogenomic test results because of insufficient education and training. Evidence-based, updated, and freely available resources such as the Clinical Pharmacogenetics Implementation Consortium guidelines can help pharmacists interpret and apply pharmacogenomic test results to patient care. Although gaps for the application of pharmacogenomic information exist, this commentary aims to demystify the interpretation of pharmacogenomic test results and empower pharmacists to apply genetic data alongside other clinical variables to optimize medication-related outcomes for their patients. An “ABCD” framework is proposed to guide pharmacists through the steps: (1) Actionability—Are the gene(s) clinically relevant for the patient? (2) Be Mindful of Limitations—What are the caveats with pharmacogenomic test results and reports? (3) Clinical Practice Guidelines—How do you use pharmacogenomic test results to guide clinical decision-making? and (4) Document and Discuss—How do you educate the patient about their pharmacogenomic test results and document the results for future use? Key concepts are illustrated using a psychiatric patient case example.

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解码药物基因组学检验解释并应用于患者护理
药物基因组学是一个不断发展的医学领域,临床实践中的药剂师有机会利用基因数据对药物进行个体化选择和用药。然而,由于缺乏足够的教育和培训,许多执业药剂师可能觉得自己不具备解读药物基因组学检测结果的能力。以证据为基础的、最新的、免费的资源,如临床药物遗传学实施联合会指南,可以帮助药剂师解读药物基因组学检测结果并将其应用于患者护理。尽管在应用药物基因组学信息方面还存在差距,但本评论旨在揭开药物基因组学检测结果解读的神秘面纱,使药剂师有能力将基因数据与其他临床变量一起应用,以优化患者的用药相关结果。本文提出了一个 "ABCD "框架,以指导药剂师完成以下步骤:(1) 可操作性--基因是否与患者的临床相关?(2)注意局限性--药物基因组学检测结果和报告有哪些注意事项?(3) 临床实践指南--如何利用药物基因组学检测结果指导临床决策? (4) 记录和讨论--如何让患者了解药物基因组学检测结果并记录结果以备将来使用?通过一个精神病患者的案例来说明关键概念。
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