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Choudhary RP, Siddalingegowda SM. Exploring the need and potential of ambulatory pharmacy practice for empowering patient and care delivery in India. FRONTIERS IN HEALTH SERVICES 2024; 4:1399621. [PMID: 39165627 PMCID: PMC11333453 DOI: 10.3389/frhs.2024.1399621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/22/2024] [Indexed: 08/22/2024]
Abstract
In recent years, rapidly changing disease profile patterns, shortage & uneven utilization of healthcare professionals contributed massive burden on the Indian healthcare system, which resulted in varying, fragmented, inconsistent healthcare delivery to the patients and poor patient management. Patients often face and experience many challenges like lack of accessibility, poor patient-healthcare provider relationships, and inadequate quality of care, resulting in unnecessary economic burden in managing their health conditions. Thus Indian healthcare reform is essential in enhancing its capacity to fulfill patients' health needs that can be addressed by focusing on key sustainable strategies and initiatives meant for enhancing coordination of care, expanding services accessibility, redeveloping healthcare infrastructure, implementing workforce innovation and strong governance with the incorporation of core principles such as patient-centeredness, integrated care and collaborative care approaches. The clinical and ambulatory pharmacy practice are fragment of the healthcare delivery which delivers pharmaceutical care and fulfils the needs of patients across healthcare settings. This paper focuses on the present & future perspectives of ambulatory pharmacy practice in India and the factors to be considered for implementing it in patient care.
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Affiliation(s)
| | - Srikanth M. Siddalingegowda
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore, India
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Senćanski D, Tadić I, Jocić D, Marinković V. Perceived importance of emotional intelligence for clinical pharmacy practice and suggested improvements: a focus group study of postgraduate pharmacists. Int J Clin Pharm 2024:10.1007/s11096-024-01748-4. [PMID: 38861045 DOI: 10.1007/s11096-024-01748-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/30/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Emotional intelligence (EI) is a critical set of skills that impacts clinical pharmacists' well-being and positively influences high-level patient-centred care. Describing pharmacists' perceptions may support the integration of EI development approaches into their professional development continuum. AIM The aim of this study was to analyse pharmacists' perceptions of the characteristics of emotionally intelligent clinical pharmacists, the importance of EI in clinical practice, and educational models and approaches to enhancing EI. METHOD A qualitative study with a focus group methodology was conducted with pharmacy practitioners using a semi-structured guide grounded in the EI competency framework and existing qualitative research methodology practices. Purposive sampling was conducted until information and meaning saturation occurred. The focus group recordings were transcribed and independently coded by two researchers. The conventional content analysis of qualitative data was applied with the inductive thematic approach at its core. RESULTS According to the 17 focus group participants, emotionally intelligent clinical pharmacists are perceived as self-confident communicators who control and manage emotions, work well under pressure, and handle every situation effectively. Emotional self-control, self-awareness, awareness of others, tolerance, understanding, and empathy have emerged as key EI competencies required for challenges in clinical practice. EI lectures with reflections from clinical applications, behaviour modelling, and behaviour-changing methods were perceived to be of particular importance for pharmacist education and development programmes. CONCLUSION Postgraduate pharmacy practitioners perceived EI competencies as necessary for their professional success and high-quality patient-centred care. They suggested that EI competencies be a focal point in pharmacy professional development programmes.
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Affiliation(s)
- Dejan Senćanski
- PhD Programme, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, 11000, Belgrade, Serbia.
| | - Ivana Tadić
- Department of Clinical Pharmacy, Innsbruck University, Innsbruck, Austria
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Dragana Jocić
- BENU Pharmacy, PHOENIX Group Serbia, Belgrade, Serbia
- Faculty of Pharmacy, University Business Academy in Novi Sad, Novi Sad, Serbia
| | - Valentina Marinković
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
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Georgiopoulos K, Manthou P, Korompeli A, Vasileiou P, Lioliousis G, Dainavas D, Pietri I. Patients' Satisfaction With Pharmaceutical Care Services Provided During COVID Pandemic: Experience From Greece. Cureus 2023; 15:e37743. [PMID: 37214066 PMCID: PMC10192945 DOI: 10.7759/cureus.37743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction Private pharmacies can contribute to the health care system through primary care. Purpose The purpose of this study is to determine patients' expectations of pharmaceutical care services during covid pandemic in order to measure the level of patient satisfaction provided by the Greek healthcare system. Also, it is important to identify the associated factors that might affect patient satisfaction. Material and Method The sample of the study consisted of 168 customers of pharmacies in Athens. A patient satisfaction survey was conducted at health facilities operating in Athens. Data regarding socio-demographic characteristics and parameters that measure patients' expectations and satisfaction were collected through a closed-ended questionnaire that had been tested for validity and reliability. The patient's point of view was evaluated based on their expectation and perception of the pharmaceutical care services they had received. Data were entered into SPSS version 22 (IBM Corp, Armonk, NY ), and descriptive statistics, cross-tabs, and binary logistic regressions were utilized. P < 0.05 was used to declare association. Results About 89.3% of the participants were insured in the Greek health system. The main reason for visiting the pharmacy was the purchase of medicines and products (95.2%), vaccinations (19.6%), and consulting services for first aid (17.3%). The pharmacist was rated for his courtesy, willingness, friendliness, and reliability. Only 48.2% of participants knew that the pharmacy provided primary care services during the pandemic. The most common services provided were blood pressure measurement and intramuscular injections. Around 64.2% of them were fully satisfied. Pharmacists in primary care teams are uniquely positioned to facilitate practice expansion and make medicine a trusted resource for physicians, as well as improve health outcomes for patients. Conclusions The pharmacy has a leading role in health care due to easy access, and fast and immediate service. Patient-clients in Greek society trust their pharmacist as a health professional. Further research is suggested to ensure that through the delivery of health services by pharmacies, the cost of primary care could be lower.
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Affiliation(s)
| | - Panagiota Manthou
- Nursing, National and Kapodistrian University of Athens, Athens, GRC
| | - Anna Korompeli
- ICU GONK "Agioi Anargyroi" General Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Panagiotis Vasileiou
- Laboratory of Histology & Embryology, National and Kapodistrian University of Athens, Athens, GRC
- Critical Care Unit, Thoracic Diseases General Hospital Sotiria, Athens, GRC
| | - Georgios Lioliousis
- Intensive Care Unit, 1st Department Respiratory Medicine, Thoracic Diseases General Hospital Sotiria, Athens, GRC
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Brown JT, McGonagle E, Seifert R, Speedie M, Jacobson PA. Addressing disparities in pharmacogenomics through rural and underserved workforce education. Front Genet 2023; 13:1082985. [PMID: 36726715 PMCID: PMC9884975 DOI: 10.3389/fgene.2022.1082985] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Introduction: While pharmacogenomic (PGx) testing is routine in urban healthcare institutions or academic health centers with access to existing expertise, uptake in medically-underserved areas is lagging. The primary objective of this workforce education program is to extend access to didactic, case-based and clinical PGx training for pharmacists serving rural Minnesota and populations experiencing health disparities in Minnesota. Methods: A PGx workforce training program funded through the Minnesota Department of Health was offered through the University of Minnesota College of Pharmacy (COP) to pharmacists working in rural and/or underserved areas in the state of Minnesota. Learning activities included a 16-week, asynchronous PGx didactic course covering PGx topics, a 15-min recorded presentation, an in-person PGx case-based workshop, and a live international PGx Conference hosted by the University of Minnesota COP and attendance at our PGx Extension of Community Health Outcomes (ECHO). Results: Twenty-nine pharmacists applied for the initial year of the program, with 12 (41%) being accepted. Four (33%) practiced in a hospital setting, four (33%) in retail pharmacy, two (17%) in managed care, and two (17%) in other areas. The majority had not implemented a PGx program as part of their practice, although nearly all responded definitely or probably yes when asked if they expected their organization to increase its use of PGx testing services over the next three years. All participants either strongly or somewhat agreed that this program helped them identify how and where to access clinical PGx guidelines and literature and improved their ability to read and interpret PGx test results. Eight participants (67%) strongly or somewhat agreed that they expected to increase the number of PGx consultations in their practice, while ten (83%) strongly or somewhat agreed they would be able to apply what they learned in this program to their practice in the next six months to a year. Discussion: This novel PGx training program focused exclusively on pharmacists in rural and/or underserved areas with a delivery method that could be accomplished conveniently and remotely. Although most participants' organizations had yet to implement PGx testing routinely, most anticipated this to change in the next few years.
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Affiliation(s)
- Jacob T. Brown
- Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota College of Pharmacy, Duluth, MN, United States,*Correspondence: Jacob T. Brown,
| | - Erin McGonagle
- Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN, United States
| | - Randall Seifert
- Pharmaceutical Care and Health Systems, University of Minnesota College of Pharmacy, Minneapolis, MN, United States
| | - Marilyn Speedie
- Medicinal Chemistry, University of Minnesota College of Pharmacy, Minneapolis, MN, United States
| | - Pamala A. Jacobson
- Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN, United States
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O'Shea J, Ryan C, Gallagher J, O'Brien C, Morris C, Dwyer E, Laughlin JM, Fitzpatrick L, O'Meara M, Kelly S, Knox S, Ledwidge M. Public perceptions of pharmacogenomic services in Ireland - Are people with chronic disease more likely to want service availability than those without? A questionnaire study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 8:100182. [PMID: 36200068 PMCID: PMC9529536 DOI: 10.1016/j.rcsop.2022.100182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 11/26/2022] Open
Abstract
Background As pharmacogenomic services begin to emerge in primary care, the insight of the public is crucial for its integration into clinical practice. Objectives To establish perceptions of pharmacogenomics (awareness, understanding, openness to availability, perceived benefits and concerns, willingness to pay, and service setting) and investigate if they differ between those with and without chronic disease(s). Methods An anonymous, online questionnaire generated using Qualtrics® and circulated via social media and posters placed in eight participating community pharmacies was conducted with Irish adults. The questions were designed to consider existing literature on patient perceptions of pharmacogenomics. Descriptive statistics were used to summarize questionnaire responses. Chi-square test was used to compare categorical variables, while independent sample t-test and one-way ANOVA were used to compare the mean values of two (with and without chronic disease) and three groups (multimorbidity (two or more chronic conditions) and polypharmacy (prescribed four or more regular medicines) (MMPP), a single chronic disease, and those without existing medical conditions) respectively Logistic regression was used to evaluate age and gender adjusted associations of chronic disease(s) with responses. A p-value <0.05 was considered statistically significant. Results A total of 421 responses were received, 30% (n = 120) of whom reported having a chronic disease. Overall, respondents reported low awareness (44%, n = 166) and poor knowledge (55%, n = 212) of pharmacogenomics. After explaining pharmacogenomics to respondents, patients with chronic disease(s) were 2.17 times more likely (p < 0.001) to want pharmacogenomic services availability than those without existing conditions, adjusted for age and gender (driven by preferences of those with MMPP than those with single chronic disease). Respondents demonstrated a high level of interest and noted both the potential benefits and downsides of pharmacogenomic testing. Willingness-to-pay was not associated with having a chronic disease and respondents were more positive about primary care (community pharmacy or general practice) rather than hospital-based pharmacogenomics implementation. Conclusion The Irish public in general and those with chronic disease in particular are strongly supportive of pharmacogenomic testing, highlighting an unmet need for its incorporation in medicines optimization. These data underline the need for more research on the implementation of community-based pharmacogenomics services for MMPP patients and ubiquitous pharmacogenomics education programs.
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Wongvedvanij R, Darawong C. Patients’ perception toward the service quality of community pharmacies for non-prescription medicines during the COVID-19 pandemic. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2105900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Ramida Wongvedvanij
- Graduate College of Management, Sripatum University Chonburi Campus, Muang, Thailand
| | - Chonlatis Darawong
- Graduate College of Management, Sripatum University Chonburi Campus, Muang, Thailand
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Park SK, Daugherty KK, Kolluru S, Lebovitz L, Gunaseelan S, Janetski BK, Vellurattil RP, Gortney J. Rethinking the Pharmacy Workforce Crisis by Exploring Unconventional and Emerging Career Pathways and Training. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:8773. [PMID: 34697019 PMCID: PMC10159434 DOI: 10.5688/ajpe8773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/27/2021] [Indexed: 05/06/2023]
Abstract
Given the limited availability of conventional pharmacy positions, pharmacy programs face a challenge in ensuring that all graduates obtain jobs that fulfill their goals and ambitions. Thus, it is imperative to explore and discuss unconventional but promising positions, specifically regarding their availability and needs. In exploring these positions, it is important to recognize technical and nontechnical skill sets that pharmacy graduates possess at graduation, identify unique pathways to help students explore job alternatives, and educate faculty and students about employment opportunities beyond the traditional setting if desired or necessary. Students must become aware of the opportunities that exist in both conventional (pharmacist clinician) and unconventional (pharmacist innovator) pharmacy careers and be able to articulate the translational skills from their training. Pharmacy programs and faculty can better support students by fostering the development and marketing of their skills.
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Affiliation(s)
- Sharon K Park
- Notre Dame of Maryland University, School of Pharmacy, Baltimore, Maryland
| | - Kimberly K Daugherty
- Sullivan University, College of Pharmacy and Health Sciences, Louisville, Kentucky
| | - Srikanth Kolluru
- Keck Graduate Institute, School of Pharmacy and Health Sciences, Claremont, California
| | - Lisa Lebovitz
- University of Maryland, School of Pharmacy, Baltimore, Maryland
| | - Simi Gunaseelan
- Texas A&M University, Irma Lerma Rangel School of Pharmacy, Kingsville, Texas
| | | | | | - Justine Gortney
- Wayne State University, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, Michigan
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Sakon CM, Tillman EM. Pharmacogenomics: a tool to improve medication safety and efficacy in patients with cystic fibrosis. Pharmacogenomics 2022; 23:559-556. [PMID: 35670256 DOI: 10.2217/pgs-2022-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cystic fibrosis is a genetic, multiorgan system disease that involves the use of many medications to control symptoms associated with the underlying condition. Many of these medications have Clinical Pharmacogenetics Implementation Consortium evidence-based guidelines for pharmacogenomics that are available to guide dosing. The aim of this article is to review relevant literature and evaluate the utility of preemptive pharmacogenomics testing for persons with cystic fibrosis and propose a pharmacogenomics panel that could be considered standard of care for persons with cystic fibrosis.
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Affiliation(s)
- Colleen M Sakon
- Pharmacy Department, Indiana University Health, Indianapolis, IN, USA
| | - Emma M Tillman
- Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, IN, USA
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O'Shea J, Ledwidge M, Gallagher J, Keenan C, Ryan C. Pharmacogenetic interventions to improve outcomes in patients with multimorbidity or prescribed polypharmacy: a systematic review. THE PHARMACOGENOMICS JOURNAL 2022; 22:89-99. [PMID: 35194175 PMCID: PMC8975737 DOI: 10.1038/s41397-021-00260-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 01/11/2023]
Abstract
Conventional medicines optimisation interventions in people with multimorbidity and polypharmacy are complex and yet limited; a more holistic and integrated approach to healthcare delivery is required. Pharmacogenetics has potential as a component of medicines optimisation. Studies involving multi-medicine pharmacogenetics in adults with multimorbidity or polypharmacy, reporting on outcomes derived from relevant core outcome sets, were included in this systematic review. Narrative synthesis was undertaken to summarise the data; meta-analysis was inappropriate due to study heterogeneity. Fifteen studies of diverse design and variable quality were included. A small, randomised study involving pharmacist-led medicines optimisation, including pharmacogenetics, suggests this approach could have significant benefits for patients and health systems. However, due to study design heterogeneity and the quality of the included studies, it is difficult to draw generalisable conclusions. Further pragmatic, robust pharmacogenetics studies in diverse, real-world patient populations, are required to establish the benefit of multi-medicine pharmacogenetic screening on patient outcomes.
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Affiliation(s)
- Joseph O'Shea
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Mark Ledwidge
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Joseph Gallagher
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | | | - Cristín Ryan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.
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10
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Emotional Intelligence and Pharmaceutical Care: A systematic review. J Am Pharm Assoc (2003) 2022; 62:1133-1141.e2. [DOI: 10.1016/j.japh.2022.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/25/2022] [Accepted: 02/26/2022] [Indexed: 11/15/2022]
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Jarrar Y, Musleh R, Ghanim M, AbuKhader I, Jarrar Q. Assessment of the need for pharmacogenomics education among pharmacists in the West Bank of Palestine. Int J Clin Pract 2021; 75:e14435. [PMID: 34191402 DOI: 10.1111/ijcp.14435] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 05/29/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Pharmacogenomics testing aims to optimise therapy and reduce the inter-individual variation in drug response. One of the major barriers against the implementation of pharmacogenomics testing is the low level of knowledge on the topic. AIMS This study aimed to evaluate the need for pharmacogenomics education among pharmacists in the West Bank of Palestine. METHODS This study was cross-sectional and included 370 pharmacists, among different cities in the West Bank of Palestine between October and December 2020. The questionnaire consisted of 25 close-ended questions that evaluated the exposure to pharmacogenomics education, attitude toward the role of pharmacogenomics testing in clinical practice and self-capability of pharmacists in pharmacogenomics testing. RESULTS It was found that 60% of the respondents disagreed that pharmacogenomics was an integral part of the pharmacy school curriculum and/or experiential education. The vast majority of the respondents (94%) agreed that pharmacists should be required to have some knowledge of pharmacogenomics. The majority of the respondents (88.6%) believe that pharmacogenomics testing will improve pharmacists' ability to more effectively control drug therapy expenditures. However, only 38% of the respondents could identify medications that require pharmacogenomics testing, and only 35.1% could identify reliable sources of information regarding pharmacogenomics for healthcare providers and patients. CONCLUSION It is seen from the results of this study that there is a high need to learn about pharmacogenomics testing, which can help the pharmacists make pharmacotherapy decisions. Additionally, current pharmacists have low self-confidence in making decisions depending on the results of pharmacogenomics testing. It is recommended to increase the exposure of pharmacogenomics knowledge by including the subject in courses and workshops in pharmacy school curricula in the West Bank of Palestine.
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Affiliation(s)
- Yazun Jarrar
- Department of Pharmacy, College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Rami Musleh
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mustafa Ghanim
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Imad AbuKhader
- Faculty of Nursing, Arab American University, Jenin, Palestine
| | - Qais Jarrar
- Department of Pharmaceutical Science, Al-Isra'a University, Amman, Jordan
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Tillman EM, Beavers CJ, Afanasjeva J, Momary KM, Strnad KG, Yerramilli A, Williams AM, Smith BA, Florczykowski B, Fahmy M. Current and future state of clinical pharmacist‐led precision medicine initiatives. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Monica Fahmy
- American College of Clinical Pharmacy Lenexa Kansas USA
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13
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Annereau M, Toussaint B, Dufaÿ Wojcicki A, Dufaÿ S, Diaz Salmeron R, Boudy V. [2D-3D printing in hospital pharmacies, what roles and challenges?]. ANNALES PHARMACEUTIQUES FRANÇAISES 2021; 79:361-374. [PMID: 33515591 DOI: 10.1016/j.pharma.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
The additive technology or 2D and 3D printing are increasingly used in various industrial fields, from aeronautics to mechanics but also in the fields of health such as dentistry or for bone reconstructions. These techniques have been studied for about fifteen years by the academic community in the pharmaceutical field (medical device and drug), and recently they have started to be applied to produce drugs in industry and in hospitals. Indeed, the Food and Drug Administration approved in August 2015 the marketing of the first drug printed by additive technique, then in 2018 the first clinical trial using 3D printed drugs was carried out in Great Britain by a hospital pharmacy. 2D-3D printing is presented as one of the tools of a more personalized medicine, the techniques of additive printing allowing the production of tabs containing several drugs in one tab (polypills) and the development of custom modified-releases drugs. This approach could allow better acceptance of the finished product and secure manufacturing. The objective of this work is to highlight relevant printing technologies for implementation in hospital pharmacies, and to see how these technologies could lead to a change in pharmaceutical practices, to improve patient care.
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Affiliation(s)
- M Annereau
- Département recherche et développement pharmaceutique, Agencegénérale des équipements et produits de santé (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), 7, rue du Fer-à-Moulin, 75005 Paris, France
| | - B Toussaint
- Département recherche et développement pharmaceutique, Agencegénérale des équipements et produits de santé (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), 7, rue du Fer-à-Moulin, 75005 Paris, France; Université de Paris, CNRS, Inserm, UTCBS, Unité des technologies chimiques et biologiques pour la santé, 75006 Paris, France
| | - A Dufaÿ Wojcicki
- Département recherche et développement pharmaceutique, Agencegénérale des équipements et produits de santé (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), 7, rue du Fer-à-Moulin, 75005 Paris, France
| | - S Dufaÿ
- Département recherche et développement pharmaceutique, Agencegénérale des équipements et produits de santé (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), 7, rue du Fer-à-Moulin, 75005 Paris, France
| | - R Diaz Salmeron
- Département recherche et développement pharmaceutique, Agencegénérale des équipements et produits de santé (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), 7, rue du Fer-à-Moulin, 75005 Paris, France
| | - V Boudy
- Département recherche et développement pharmaceutique, Agencegénérale des équipements et produits de santé (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), 7, rue du Fer-à-Moulin, 75005 Paris, France; Université de Paris, CNRS, Inserm, UTCBS, Unité des technologies chimiques et biologiques pour la santé, 75006 Paris, France.
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14
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Osama S, Wirth F, Zahra G, Barbara C, Xuereb RG, Camilleri L, Azzopardi LM. CYP2C19*2 genetic polymorphism and incidence of in-stent restenosis in patients on clopidogrel: a matched case-control study. Drug Metab Pers Ther 2021; 37:155-161. [PMID: 34851561 DOI: 10.1515/dmpt-2021-0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/01/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The cytochrome P450 2C19*2 (CYP2C19*2) genetic polymorphism is associated with reduced clopidogrel bioactivation, increasing the risk of atherothrombotic complications after percutaneous coronary intervention (PCI). In-stent restenosis (ISR) is a complication that limits the long-term prognosis of PCI. The aim was to investigate the association between presence of the CYP2C19*2 allele and ISR within one-year after PCI in patients prescribed dual antiplatelet therapy with aspirin and clopidogrel. METHODS Sixty patients with angiographically-confirmed drug eluting stent (DES)-ISR within 12 months post-PCI when on DAPT with aspirin and clopidogrel were retrospectively identified (Cases). Another 60 patients with no documented ISR post-PCI in the study period (Controls) were case-matched for age, gender, ethnicity, diabetes mellitus and estimated glomerular filtration rate value, and were invited for CYP2C19*2 genotyping. The association between presence of the CYP2C19*2 allele and ISR was analysed using the Fisher's Exact test and binary logistic regression. RESULTS Twenty-six (43.3%) cases and 5 (8.3%) controls were carriers of one or two CYP2C19*2 alleles. As to non-carrier status of the CYP2C19*2 allele, 34 (56.7%) cases and 55 (91.7%) controls were identified. The association between CYP2C19*2 carrier status and DES-ISR within one-year post-PCI was statistically significant (p<0.001) in both the univariate and multivariate analysis. CONCLUSIONS The proportion of patients who were carriers of one or two CYP2C19*2 alleles who presented with DES-ISR within one-year post-PCI while on clopidogrel was significantly higher compared to patients with no documented ISR.
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Affiliation(s)
- Sara Osama
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Francesca Wirth
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Graziella Zahra
- Department of Pathology, Molecular Diagnostics Unit, Mater Dei Hospital, Msida, Malta
| | - Christopher Barbara
- Department of Pathology, Molecular Diagnostics Unit, Mater Dei Hospital, Msida, Malta
| | | | - Liberato Camilleri
- Department of Statistics and Operations Research, Faculty of Science, University of Malta, Msida, Malta
| | - Lilian M Azzopardi
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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15
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Bright D, Petry N, Roath E, Reckow E, Chavour S. Barriers, solutions, and effect of using pharmacogenomics data to support opioid prescribing. J Manag Care Spec Pharm 2020; 26:1597-1602. [PMID: 33252002 PMCID: PMC10390958 DOI: 10.18553/jmcp.2020.26.12.1597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Opioid use and misuse are continued issues facing clinicians across all aspects of health care. As clinicians struggle to effectively manage opioid prescribing, pharmacogenomics (PGx) further offers the prescriber an improved ability to understand the potential for an individual patient's genetics to influence opioid efficacy and safety. When PGx data are available at the point of initial prescribing, clinicians can apply that data to drug therapy selection. However, barriers continue to exist relative to PGx data sharing and interpretation, which have created difficulties for widespread PGx implementation. This article briefly describes potential barriers to PGx data integration, strategies to overcome those barriers, and the potential positive effect of successful data sharing on opioid prescribing. Prescription drug monitoring programs (PDMPs) have been successfully operationalized to share controlled substance prescribing data across health care settings. Such data sharing enables clinicians to, among other things, better understand risks associated with misuse. Because a relatively limited volume of PGx data is currently pertinent to opioid prescribing, such PGx data could be added to PDMPs as a way to communicate genetic information within current technology platforms. Not only would this integrate into existing clinical workflow models where PDMP data are accessed at this point of prescribing and/or dispensing, but associated clinical guidance for PGx data interpretation in the context of opioids could be integrated into the workflow process. Such clinical decision support could be provided directly through the PDMP interface for uniformity or could be provided via systems that access PDMP data. Clinical, economic, and policy implications of the inclusion of PGx data within PDMPs are also discussed. Through harnessing PDMP for data sharing, multiple barriers to PGx implementation could be mitigated, and clinicians may have better access to PGx data to optimize opioid prescribing. DISCLOSURES: No outside funding supported this study. Bright has a patent pending related to opioid use disorder risk assessment that includes genetic information and was a collaborator on funded research projects with pharmacogenomics-related companies. Petry has been a consultant to the North Dakota Department of Health and has received grants from IGNITE I and IGNITE II (NIH), unrelated to this work. The other authors are aware of no financial conflicts of interest.
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Affiliation(s)
- David Bright
- Ferris State University College of Pharmacy, Big Rapids, MI
| | - Natasha Petry
- North Dakota State University School of Pharmacy, Fargo ND
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16
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Nagy M, Tsermpini EE, Siamoglou S, Patrinos GP. Evaluating the current level of pharmacists' pharmacogenomics knowledge and its impact on pharmacogenomics implementation. Pharmacogenomics 2020; 21:1179-1189. [PMID: 33118449 DOI: 10.2217/pgs-2020-0076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The pharmacists' role is potentially vital in the growing field of personalized medicine, and well-defined guidelines and knowledge that support this role need to be established. To address the knowledge gap, over the past two decades, pharmacy schools have started providing pharmacogenomics-related courses, a field that overlaps with pharmacy and personalized medicine. Given the fact that pharmacists lead 50% of the Clinical Pharmacogenetics Implementation Consortium implementers' sites, their role can be particularly crucial to move forward the integration of precision medicine in clinical practice. Herein, we aim to identify the educational challenges for pharmacogenomics integration into clinical practice and their impact on pharmacists' knowledge and confidence, in addition to underscoring pharmacists' role in pharmacogenomics as a whole.
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Affiliation(s)
- Mohamed Nagy
- Department of Pharmaceutical Services, Personalised Medication Management Unit, Children's Cancer Hospital Egypt (57357), Cairo, Egypt
| | | | - Stavroula Siamoglou
- Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - George P Patrinos
- Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece.,Zayed Center of Health Sciences, United Arab Emirates University, Al-Ain, UAE.,Department of Pathology, College of Medicine & Health Sciences, United Arab Emirates University, Al-Ain, UAE
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17
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Knowledge and Attitudes of Medical and Health Science Students in the United Arab Emirates toward Genomic Medicine and Pharmacogenomics: A Cross-Sectional Study. J Pers Med 2020; 10:jpm10040191. [PMID: 33114420 PMCID: PMC7711592 DOI: 10.3390/jpm10040191] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/17/2020] [Accepted: 10/22/2020] [Indexed: 02/05/2023] Open
Abstract
Medical and health science students represent future health professionals, and their perceptions are essential to increasing awareness on genomic medicine and pharmacogenomics. Lack of education is one of the significant barriers that may affect health professional’s ability to interpret and communicate pharmacogenomics information and results to their clients. Our aim was to assess medical and health science students’ knowledge, attitudes and perception for a better genomic medicine and pharmacogenomics practice in the United Arab Emirates (UAE). A cross-sectional study was conducted using a validated questionnaire distributed electronically to students recruited using random and snowball sampling methods. A total of 510 students consented and completed the questionnaire between December 2018 and October 2019. The mean knowledge score (SD) for students was 5.4 (±2.7). There were significant differences in the levels of knowledge by the year of study of bachelor’s degree students, the completion status of training or education in pharmacogenomics (PGX) or pharmacogenetics and the completion of an internship or study abroad program (p-values < 0.05. The top two barriers that students identified in the implementation of genomic medicine and pharmacogenomics were lack of training or education (59.7%) and lack of clinical guidelines (58.7%). Concerns regarding confidentiality and discrimination were stated. The majority of medical and health science students had positive attitudes but only had a fair level of knowledge. Stakeholders in the UAE must strive to acquaint their students with up-to-date knowledge of genomic medicine and pharmacogenomics.
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18
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Genomics and Pharmacogenomics Knowledge, Attitude and Practice of Pharmacists Working in United Arab Emirates: Findings from Focus Group Discussions-A Qualitative Study. J Pers Med 2020; 10:jpm10030134. [PMID: 32962013 PMCID: PMC7563679 DOI: 10.3390/jpm10030134] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/29/2020] [Accepted: 09/15/2020] [Indexed: 02/05/2023] Open
Abstract
(1) Background: Genomics and pharmacogenomics are relatively new fields in medicine in the United Arab Emirates (UAE). Understanding the knowledge, attitudes and current practices among pharmacists is an important pillar to establish the roadmap for implementing genomic medicine and pharmacogenomics; (2) Methods: A qualitative method was used, with focus group discussions (FGDs) being conducted among pharmacists working in public and private hospitals in Abu Dhabi Emirate. Snowball sampling was used. Thematic inductive analysis was performed by two researchers independently. NVIVO software was used to establish the themes; (3) Results: Lack of knowledge of genomics and pharmacogenomics among pharmacists was one of the most prominent findings. Therefore, the role of pharmacist in making the right decisions was highlighted to be a barrier for pharmacogenomics implementation in the UAE. Pharmacists have a positive attitude toward pharmacogenomics, but they are preoccupied with concern of confidentiality. In addition, religion and culture shadowed their attitudes toward genetic testing; (4) Conclusions: It is highly recommended to introduce new courses and training workshops for healthcare providers to improve the opportunities for genomics and pharmacogenomics application in the UAE. Pharmacists agreed that the health authorities should take the lead for improving trust and confidence in the system for a better future in the era of genomics and pharmacogenomics.
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19
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Bragazzi NL, Mansour M, Bonsignore A, Ciliberti R. The Role of Hospital and Community Pharmacists in the Management of COVID-19: Towards an Expanded Definition of the Roles, Responsibilities, and Duties of the Pharmacist. PHARMACY 2020; 8:E140. [PMID: 32784696 PMCID: PMC7558051 DOI: 10.3390/pharmacy8030140] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 12/23/2022] Open
Abstract
Since late December 2019, a novel, emerging coronavirus was identified as the infectious agent responsible for a generally mild but sometimes severe and even life-threatening disease, termed as "coronavirus disease 2019" (COVID-19). The pathogen was initially named as "2019 novel coronavirus" (2019-nCoV) and later renamed as "Severe Acute Respiratory Coronavirus type 2" (SARS-CoV-2). COVID-19 quickly spread from the first epicenter, the city of Wuhan, province of Hubei, mainland China, into neighboring countries, and became a global pandemic. As of July 15th 2020, the outbreak is still ongoing, with SARS-CoV-2 affecting 213 countries and territories. The coronavirus has caused a dramatic toll of deaths and imposed a severe burden, both from a societal and economic point of view. COVID-19 has challenged health systems, straining and overwhelming healthcare facilities and settings, including hospital and community pharmacies. On the other hand, COVID-19 has propelled several changes. During the last decades, pharmacy has shifted from being products-based and patient-facing to being services-based and patient-centered. Pharmacies have transitioned from being compounding centers devoted to the manipulation of materia medica to pharmaceutical centers, clinical pharmacies and fully integrated "medical-pharmaceutical networks", providing a significant range of non-prescribing services. Moreover, roles, duties and responsibilities of pharmacists have paralleled such historical changes and have known a gradual expansion, incorporating new skills and reflecting new societal demands and challenges. The COVID-19 outbreak has unearthed new opportunities for pharmacists: community and hospital pharmacists have, indeed, played a key role during the COVID-19 pandemic, suggesting that a fully integrated, inter-sectoral and inter-professional collaboration is necessary to face crises and public health emergencies. Preliminary, emerging evidence seems to suggest that, probably, a new era in the history of pharmacies ("the post-COVID-19 post-pharmaceutical care era") has begun, with community pharmacists acquiring more professional standing, being authentic heroes and frontline health workers.
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Affiliation(s)
- Nicola Luigi Bragazzi
- Department of Health Sciences (DISSAL), Postgraduate School of Public Health, Genoa University, 16132 Genoa, Italy
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada
| | - Muhammad Mansour
- Department of Surgery A, Galilee Medical Center, Nahariya, Faculty of Medicine of the Galilee, Bar-Ilan University, Safed 5290002, Israel;
- Division of General Surgery, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada
| | - Alessandro Bonsignore
- Section of Legal and Forensic Medicine, Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
| | - Rosagemma Ciliberti
- Section of History of Medicine and Bioethics, Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
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20
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Petit C, Croisetière A, Chen F, Laverdière I. Are pharmacists from the province of Quebec ready to integrate pharmacogenetics into their practice. Pharmacogenomics 2020; 21:247-256. [DOI: 10.2217/pgs-2019-0144] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The pharmacists are identified as one of the best positioned health professionals to lead intercollaborative efforts in tailoring medication based on pharmacogenetic information. As pharmacotherapy specialists, they can take on a prominent role in ordering and interpreting pharmacogenetic test results and then guiding optimal drug selection and dose based on those results. Participants & methods: To assess the readiness of pharmacists and trainees in the province of Quebec to assume this role, we surveyed their knowledge in (pharmaco)genetics, their confidence in their ability to use pharmacogenetics and their attitude toward the integration of this tool in clinical practice. Results: A total of 99 pharmacists (community: 67.7%, hospital: 24.2% and other: 8.1%) and 36 students volunteered in a self-administered online survey. About 50% of the questions on the participants’ knowledge are answered correctly, with a stepwise increase of right answers with hours of education in (pharmaco)genetics (51.2, 63.8 and 76.7% for <5, 5–25 and >25 h respectively; p < 0.0001). While the majority of participants believe that pharmacogenetics will gain more room in their future practice (80.7%), the overall rate of confidence in their ability to use pharmacogenetics information is low (22%) and 90.3% desire more training. Conclusion: The limited experience of pharmacists in pharmacogenetics appears to be a barrier for its integration in clinical practice.
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Affiliation(s)
- Chloé Petit
- Faculty of Pharmacy, Université Laval, Quebec, Canada
| | | | - Flora Chen
- Faculty of Pharmacy, Université Laval, Quebec, Canada
| | - Isabelle Laverdière
- Faculty of Pharmacy, Université Laval, Quebec, Canada
- Centre Hospitalier Universitaire de Québec (CHU de Québec)-Université Laval Research Center & Department of Pharmacy, CHU de Québec-Université Laval, Quebec, Canada
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21
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Alves da Costa F, Martins AP, Veiga F, Ramalhinho I, Sousa Lobo JM, Rodrigues L, Granadeiro L, Castro M, Barata P, Gomes P, Seabra V, Caramona MM. Development of a Platform to Align Education and Practice: Bridging Academia and the Profession in Portugal. PHARMACY 2020; 8:pharmacy8010011. [PMID: 31963380 PMCID: PMC7151656 DOI: 10.3390/pharmacy8010011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 01/09/2020] [Accepted: 01/14/2020] [Indexed: 11/29/2022] Open
Abstract
Limited fitness for practice may result from a mismatch between education and practice. Aiming to meet the common interests of academics and practitioners, the Portuguese Pharmaceutical Society (PPS) developed the Education and Practice Platform (EPP). The EPP includes one representative from each pharmacy faculty, and all Councils of Speciality Boards of Practice. Brainstorming with involved parties enabled sharing of interests, concerns and identifying a common path. Aims, mission, vision and values were set. The EPP’s mission is to: act as an enabler to foster the quality and adequacy of education through sharing best practices, ultimately leading to facilitate professional integration, and to foster quality development in teaching practices with recognition for autonomy in freedom to teach and to learn. Its vision is an alignment of education and practice with the PPS’ statutes to ensure validation of the competences defined for each practice area, and compliance with international guidance. Key performance indicators (KPIs) were set. Activities developed include the creation of a national forum to discuss education and practice, development of workshops on teaching methods and pharmacy internships, enhanced representation in international events and response to global and national requests. Ongoing work focuses on the creation of a common training framework in hospital and community pharmacy practice adapted to Portugal. The EPP is a worldwide case study, encouraging the development of discussion contributing to an open climate of sharing best practices, indirectly leading to foster a better alignment between education and practice. Many of these results are so far intangible in scientific terms but worth describing.
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Affiliation(s)
- Filipa Alves da Costa
- Ordem dos Farmacêuticos, Rua da Sociedade Farmacêutica, 18, 1169-075 Lisboa, Portugal; (A.P.M.); (M.M.C.)
- Correspondence: ; Tel.: +351-213191399
| | - Ana Paula Martins
- Ordem dos Farmacêuticos, Rua da Sociedade Farmacêutica, 18, 1169-075 Lisboa, Portugal; (A.P.M.); (M.M.C.)
| | - Francisco Veiga
- Faculdade de Farmácia da Universidade de Coimbra, Polo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal;
| | - Isabel Ramalhinho
- Faculdade de Ciências e Tecnologia da Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
| | - José Manuel Sousa Lobo
- Faculdade de Farmácia da Universidade do Porto, Edifício 3, Piso 3. Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal;
| | - Luís Rodrigues
- Escola de Ciências e Tecnologia da Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal;
| | - Luiza Granadeiro
- Faculdade de Ciências da Saúde da Universidade da Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal;
| | - Matilde Castro
- Faculdade de Farmácia da Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisboa, Portugal;
| | - Pedro Barata
- Faculdade de Ciências da Saúde da Universidade Fernando Pessoa, Rua Carlos da Maia, 296 4200-150 Porto, Portugal;
| | - Perpétua Gomes
- Instituto Universitário Egas Moniz, Campus Universitário, Quinta da Granja Monte de Caparica, 2829-511 Caparica, Portugal;
| | - Vítor Seabra
- Instituto Universitário de Ciências da Saúde, Rua Central de Gandra, 1317, 4585-116 Gandra, Portugal;
| | - Maria Margarida Caramona
- Ordem dos Farmacêuticos, Rua da Sociedade Farmacêutica, 18, 1169-075 Lisboa, Portugal; (A.P.M.); (M.M.C.)
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22
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Miscio G, Paroni G, Bisceglia P, Gravina C, Urbano M, Lozupone M, Piccininni C, Prisciandaro M, Ciavarella G, Daniele A, Bellomo A, Panza F, Di Mauro L, Greco A, Seripa D. Pharmacogenetics in the clinical analysis laboratory: clinical practice, research, and drug development pipeline. Expert Opin Drug Metab Toxicol 2019; 15:751-765. [PMID: 31512953 DOI: 10.1080/17425255.2019.1658742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Over the last decade, the spread of next-generation sequencing technology along with the rising cost in health management in national health systems has led to widespread use/abuse of pharmacogenetic tests (PGx) in the practice of many clinical disciplines. However, given their clinical significance, it is important to standardize these tests for having an interaction with the clinical analysis laboratory (CAL), in which a PGx service can meet these requirements. Areas covered: A diagnostic test must meet the criteria of reproducibility and validity for its utility in the clinical routine. This present review mainly describes the utility of introducing PGx tests in the CAL routine to produce correct results useful for setting up personalized drug treatments. Expert opinion: With a PGx service, CALs can provide the right tool to help clinicians to make better choices about different categories of drugs and their dosage and to manage the economic impact both in hospital-based settings and in National Health Services, throughout electronic health records. Advances in PGx also allow a new approach for pharmaceutical companies in order to improve drug development and clinical trials. As a result, CALs can achieve a powerful source of epidemiological, clinical, and research findings from PGx tests.
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Affiliation(s)
- Giuseppe Miscio
- Clinical Laboratory Analysis and Transfusional Medicine, Laboratory and Transfusional Diagnostics, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Giulia Paroni
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Paola Bisceglia
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Carolina Gravina
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Maria Urbano
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience, and Sense Organs, University of Bari Aldo Moro , Bari , Italy
| | - Carla Piccininni
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia , Foggia , Italy
| | - Michele Prisciandaro
- Clinical Laboratory Analysis and Transfusional Medicine, Laboratory and Transfusional Diagnostics, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Grazia Ciavarella
- Clinical Laboratory Analysis and Transfusional Medicine, Laboratory and Transfusional Diagnostics, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart , Rome , Italy.,Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia , Foggia , Italy
| | - Francesco Panza
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy.,Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience, and Sense Organs, University of Bari Aldo Moro , Bari , Italy
| | - Lazzaro Di Mauro
- Clinical Laboratory Analysis and Transfusional Medicine, Laboratory and Transfusional Diagnostics, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Antonio Greco
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Davide Seripa
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
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23
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Natasha Petry, Baye J, Aifaoui A, Wilke RA, Lupu RA, Savageau J, Gapp B, Massmann A, Hahn D, Hajek C, Schultz A. Implementation of wide-scale pharmacogenetic testing in primary care. Pharmacogenomics 2019; 20:903-913. [DOI: 10.2217/pgs-2019-0043] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The convergence of translational genomics and biomedical informatics has changed healthcare delivery. Institutional consortia have begun implementing lab testing and decision support for drug–gene interactions. Aggregate datasets are now revealing the impact of clinical decision support for drug–gene interactions. Given the pleiotropic nature of pharmacogenes, interdisciplinary teams and robust clinical decision support tools must exist within an informatics framework built to be flexible and capable of cross-talk between clinical specialties. Navigation of the challenges presented with the implementation of five steps to build a genetics program infrastructure requires the expertise of multiple healthcare professionals. Ultimately, this manuscript describes our efforts to place pharmacogenomics in the hands of the primary care provider integrating this information into a patient’s healthcare over their lifetime.
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Affiliation(s)
- Natasha Petry
- Sanford Health Imagenetics, Sioux Falls, SD 57105, USA
- North Dakota State University College of Health Professions Department of Pharmacy Practice, Fargo, ND 58108, USA
| | - Jordan Baye
- Sanford Health Imagenetics, Sioux Falls, SD 57105, USA
- North Dakota State University College of Health Professions Department of Pharmacy Practice, Fargo, ND 58108, USA
- South Dakota State University College of Pharmacy & Allied Health Professions, Department of Pharmacy Practice, Brookings, SD 57007, USA
| | - Aissa Aifaoui
- Sanford Health Imagenetics, Sioux Falls, SD 57105, USA
| | - Russell A Wilke
- Sanford Health Department of Internal Medicine, Sioux Falls, SD 57105, USA
- University of South Dakota, Sanford School of Medicine, Department of Internal Medicine, Sioux Falls, SD 57105, USA
| | - Roxana A Lupu
- Sanford Health Department of Internal Medicine, Sioux Falls, SD 57105, USA
- University of South Dakota, Sanford School of Medicine, Department of Internal Medicine, Sioux Falls, SD 57105, USA
| | - John Savageau
- Sanford Health Bismarck – Department of Pharmacy, Bismarck, ND 58501 USA
| | - Britni Gapp
- Sanford Health Bismarck – Department of Pharmacy, Bismarck, ND 58501 USA
| | | | - Deidre Hahn
- North Dakota State University College of Health Professions Department of Pharmacy Practice, Fargo, ND 58108, USA
| | - Catherine Hajek
- Sanford Health Imagenetics, Sioux Falls, SD 57105, USA
- University of South Dakota, Sanford School of Medicine, Department of Internal Medicine, Sioux Falls, SD 57105, USA
| | - April Schultz
- Sanford Health Imagenetics, Sioux Falls, SD 57105, USA
- University of South Dakota, Sanford School of Medicine, Department of Internal Medicine, Sioux Falls, SD 57105, USA
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