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Maruf AA, Shields M, Fryza A, Wondrasek A, Leong C, Kowalec K, Bousman C. Knowledge and perceptions of pharmacogenomics among pharmacists in Manitoba, Canada. Pharmacogenomics 2024; 25:175-186. [PMID: 38506345 DOI: 10.2217/pgs-2024-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Objective: This work was designed to describe the knowledge and perceptions of pharmacogenomics (PGx) among pharmacists in the Canadian province of Manitoba. Methods: A 40-item, web-based survey was distributed to pharmacists in Manitoba. Results: Of 74 participants, one third had some education or training in PGx, and 12.2% had used PGx test results in their practice. Participants' self-rated knowledge of PGx testing and common PGx resources (e.g., Pharmacogenomics Knowledge Base, Clinical Pharmacogenetics Implementation Consortium) was low. Most pharmacists surveyed believe that PGx can improve medication efficacy (82.4%) or prevent adverse drug reactions (81.1%). Most (91%) desired more education on PGx. Conclusion: Manitoba pharmacists reported positive perceptions toward PGx. However, they are currently underprepared to implement PGx into practice.
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Affiliation(s)
- Abdullah Al Maruf
- College of Pharmacy, University of Manitoba, Winnipeg, MB, R3E 0T5, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, R3E 3P4, Canada
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4Z6, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Meagan Shields
- Department of Medical Genetics, University of Calgary, Calgary, AB, T2N 4N2, Canada
| | - Amber Fryza
- College of Pharmacy, University of Manitoba, Winnipeg, MB, R3E 0T5, Canada
| | - Amanda Wondrasek
- College of Pharmacy, University of Manitoba, Winnipeg, MB, R3E 0T5, Canada
| | - Christine Leong
- College of Pharmacy, University of Manitoba, Winnipeg, MB, R3E 0T5, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, R3E 3P4, Canada
- Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, MB, R3E 3N4, Canada
| | - Kaarina Kowalec
- College of Pharmacy, University of Manitoba, Winnipeg, MB, R3E 0T5, Canada
- Department of Medical Epidemiology & Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Chad Bousman
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4Z6, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
- Department of Medical Genetics, University of Calgary, Calgary, AB, T2N 4N2, Canada
- Departments of Physiology & Pharmacology & Community Health Sciences, University of Calgary, Calgary, AB, T2N 1N4, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
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Li LJ, Legeay S, Gagnon AL, Frigon MP, Tessier L, Tremblay K. Moving towards the implementation of pharmacogenetic testing in Quebec. Front Genet 2024; 14:1295963. [PMID: 38234998 PMCID: PMC10791884 DOI: 10.3389/fgene.2023.1295963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/11/2023] [Indexed: 01/19/2024] Open
Abstract
Clinical implementation of pharmacogenetics (PGx) into routine care will elevate the current paradigm of treatment decisions. However, while PGx tests are increasingly becoming reliable and affordable, several barriers have limited their widespread usage in Canada. Globally, over ninety successful PGx implementors can serve as models. The purpose of this paper is to outline the PGx implementation barriers documented in Quebec (Canada) to suggest efficient solutions based on existing PGx clinics and propose an adapted clinical implementation model. We conclude that the province of Quebec is ready to implement PGx.
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Affiliation(s)
- Ling Jing Li
- Centre Intégré Universitaire de Santé et de Services Sociaux Du Saguenay-Lac-Saint-Jean (Chicoutimi University Hospital), Research Center, Saguenay, QC, Canada
- Medicine Department, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Saguenay, QC, Canada
| | - Samuel Legeay
- Centre Intégré Universitaire de Santé et de Services Sociaux Du Saguenay-Lac-Saint-Jean (Chicoutimi University Hospital), Research Center, Saguenay, QC, Canada
- Medicine Department, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Saguenay, QC, Canada
- University Angers, [CHU Angers], Inserm, CNRS, MINT, Angers, France
| | - Ann-Lorie Gagnon
- Centre Intégré Universitaire de Santé et de Services Sociaux Du Saguenay-Lac-Saint-Jean (Chicoutimi University Hospital), Research Center, Saguenay, QC, Canada
| | - Marie-Pier Frigon
- Centre Intégré Universitaire de Santé et de Services Sociaux Du Saguenay-Lac-Saint-Jean (Chicoutimi University Hospital), Research Center, Saguenay, QC, Canada
- Pediatrics Department, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Laurence Tessier
- Centre Intégré Universitaire de Santé et de Services Sociaux Du Saguenay-Lac-Saint-Jean (Chicoutimi University Hospital), Research Center, Saguenay, QC, Canada
- Pharmacology-Physiology Department, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Saguenay, QC, Canada
| | - Karine Tremblay
- Centre Intégré Universitaire de Santé et de Services Sociaux Du Saguenay-Lac-Saint-Jean (Chicoutimi University Hospital), Research Center, Saguenay, QC, Canada
- Pharmacology-Physiology Department, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Saguenay, QC, Canada
- Centre de Recherche Du Centre Hospitalier Universitaire de Sherbrooke (CR-CHUS), Sherbrooke, QC, Canada
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Wondrasek A, Fryza A, Aziz MA, Leong C, Kowalec K, Maruf AA. Knowledge, perceptions, and attitudes toward pharmacogenomics among pharmacists and pharmacy students: A systematic review. Health Sci Rep 2024; 7:e1844. [PMID: 38274140 PMCID: PMC10809028 DOI: 10.1002/hsr2.1844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/09/2023] [Accepted: 01/08/2024] [Indexed: 01/27/2024] Open
Abstract
Background and Aims Pharmacists have been recognized as one of the most qualified healthcare professionals in the clinical implementation of pharmacogenomics, yet its widespread implementation in clinical pharmacy practice has remained limited. The review aims to systematically investigate knowledge, perceptions, and attitudes toward pharmacogenomics among pharmacists and pharmacy students to inform the future delivery of pharmacogenomics education programs. Methods PubMed, MEDLINE, Embase, Scopus, and the International Pharmaceutical Abstracts were searched up to May 17, 2022. Studies were selected if they included data on pharmacists' or pharmacy students' knowledge, perception, or attitude about pharmacogenomics and were published in a peer-reviewed, English-language journal with full-text availability. Any published study not deemed original research was excluded. All included studies were critically appraised using the Center for Evidence-Based Management's critical appraisal tools. The data were descriptively analyzed and presented based on pharmacists' and pharmacy students' knowledge/awareness, perception/attitudes toward pharmacogenomic (PGx), confidence in using or interpreting PGx testing results, and their desire to get further PGx education or their most preferred method of further education. Results A combined total of 12,430 pharmacists and pharmacy students from 26 countries are represented in the 52 included studies. Despite overwhelmingly positive attitudes and perceptions toward pharmacogenomics among pharmacists and pharmacy students, an overall lack of adequate knowledge and confidence was found. The review also found a strong desire for further pharmacogenomics education among pharmacists and pharmacy students. Conclusion Pharmacists and pharmacy students have positive perceptions and attitudes toward pharmacogenomics, which is hindered by a lack of knowledge and confidence. However, inadequate control for confounders, limited representativeness of the studied population or region, and small sample sizes diminish the generalizability of the review results. Knowledge and confidence could be improved through enhanced delivery of pharmacogenomic courses within the pharmacy curriculum and continuing education programs.
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Affiliation(s)
- Amanda Wondrasek
- College of Pharmacy, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
| | - Amber Fryza
- College of Pharmacy, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
| | - Md. Abdul Aziz
- College of Pharmacy, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
- Bangladesh Pharmacogenomics Research Network (BdPGRN)DhakaBangladesh
| | - Christine Leong
- College of Pharmacy, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
- Department of Psychiatry, Max Rady College of MedicineUniversity of ManitobaWinnipegCanada
| | - Kaarina Kowalec
- College of Pharmacy, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
- Department of Medical Epidemiology and BiostatisticsKarolinska InstituteStockholmSweden
| | - Abdullah Al Maruf
- College of Pharmacy, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
- Bangladesh Pharmacogenomics Research Network (BdPGRN)DhakaBangladesh
- The Mathison Centre for Mental Health Research & Education, Cumming School of Medicine, Department of PsychiatryUniversity of CalgaryCalgaryCanada
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Hayashi M, Bousman CA. Experience, Knowledge, and Perceptions of Pharmacogenomics among Pharmacists and Nurse Practitioners in Alberta Hospitals. PHARMACY 2022; 10:pharmacy10060139. [PMID: 36412815 PMCID: PMC9680290 DOI: 10.3390/pharmacy10060139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/18/2022] [Accepted: 10/21/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Despite evidence of clinical utility and the availability of prescription guidelines, pharmacogenomics (PGx) is not broadly used in institutional settings in Canada. To inform future implementation, this study aimed to identify healthcare provider knowledge, experience, and perceptions of PGx in Alberta, Canada. METHODS An online 44-item survey was distributed to pharmacists, nurse practitioners, and physicians employed or contracted with Alberta Health Services from January to May 2022. Questions included: demographics, professional history, PGx education and exposure, knowledge, and ability to use PGx, and attitudes towards, feasibility, clinical utility, education, and implementation. RESULTS Ninety-one pharmacists, 37 nurse practitioners, and 6 physicians completed the survey. Fifty-nine percent had 10 or more years of experience, and 71% practiced in urban settings. Only one-third had training in PGx, and one-quarter had used PGx. Most respondents (63%) had no knowledge of PGx resources, including the Pharmacogenomics Knowledge Base (75%), or the Clinical Pharmacogenetics Implementation Consortium guidelines (85%). While participants agreed that they understood genetic (75%) and PGx (63%) concepts, most disagreed with their ability regarding practical applications of PGx such as translating genotype to phenotype (74%) or counselling patients on results (66%). Participants agreed on the clinical utility of PGx in preventing adverse drug reactions (80%) and enhancing medication efficacy (77%), and identified oncology (62%), cardiovascular/stroke (60%), and psychiatry (56%) as therapeutic areas to consider implementation. At present, healthcare provider knowledge (87%), cost (81%), and limited guidelines/evidence (70%) are seen as the greatest barriers to implementation. CONCLUSION Alberta healthcare providers have limited training, experience, or knowledge in PGx. However, most appear to have a positive outlook regarding clinical utility, especially within oncology, cardiology, and psychiatry. More effort is required to socialize the availability and quality of evidence and guidelines for the interpretation of PGx test results, address other knowledge gaps, and improve financial limitations.
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Affiliation(s)
- Meagan Hayashi
- Pharmacy Services, Alberta Health Services, Edmonton, AB T6G 2R3, Canada
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB T6G 2R3, Canada
- Correspondence: ; Tel.: +780-906-5344
| | - Chad A. Bousman
- Departments of Medical Genetics, Psychiatry, Physiology & Pharmacology, Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
- Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
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5
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Pépin MA, Otis AS, Tremblay Z, Boulé M, Lebel D, Major P, Lortie A, Pinchefsky E, Rossignol E, Carleton B, Bussières JF, Métras MÉ. Pharmacogenetic testing in pediatric neurology: a pragmatic study evaluating clinician and patient perceptions. Per Med 2022; 19:423-434. [PMID: 35830229 DOI: 10.2217/pme-2021-0150] [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]
Abstract
Aim: To evaluate clinicians' and patients' perceptions of pharmacogenetic testing in a clinical setting. Materials & methods: This is a pragmatic mixed-method prospective observational study. Hospital pharmacists and neurologists participated in focus groups regarding pharmacogenetic testing; patients who received pharmacogenetic testing and their community pharmacists completed surveys to assess their perception of these tests. Results: Most study participants had a positive view of pharmacogenetic testing. Three major themes were identified from the focus groups: receptiveness to pharmacogenetic testing, pharmacogenetic test characteristics and integrating pharmacogenetic tests into practice. Conclusion: The views reported are encouraging for the eventual implementation of pharmacogenetics in practice. Local integration of these tests is an essential step to improve patient care through personalized medicine.
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Affiliation(s)
- Marie-Anne Pépin
- Pharmacy Practice Research Unit & Department of Pharmacy, CHU Sainte-Justine, Montréal, Québec, H3T 1C5, Canada
| | - Anne-Sophie Otis
- Pharmacy Practice Research Unit & Department of Pharmacy, CHU Sainte-Justine, Montréal, Québec, H3T 1C5, Canada
| | - Zoë Tremblay
- Pharmacy Practice Research Unit & Department of Pharmacy, CHU Sainte-Justine, Montréal, Québec, H3T 1C5, Canada
| | - Marianne Boulé
- Pharmacy Practice Research Unit & Department of Pharmacy, CHU Sainte-Justine, Montréal, Québec, H3T 1C5, Canada
| | - Denis Lebel
- Pharmacy Practice Research Unit & Department of Pharmacy, CHU Sainte-Justine, Montréal, Québec, H3T 1C5, Canada
| | - Philippe Major
- Research Center & Division of Neurology, Department of Pediatrics, CHU Sainte-Justine, Montréal, Québec, H3T 1C5, Canada.,Department of Neuroscience, Université de Montréal, Montréal, Québec, H3T 1J4, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Québec, H3T 1J4, Canada
| | - Anne Lortie
- Research Center & Division of Neurology, Department of Pediatrics, CHU Sainte-Justine, Montréal, Québec, H3T 1C5, Canada.,Department of Neuroscience, Université de Montréal, Montréal, Québec, H3T 1J4, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Québec, H3T 1J4, Canada
| | - Elana Pinchefsky
- Research Center & Division of Neurology, Department of Pediatrics, CHU Sainte-Justine, Montréal, Québec, H3T 1C5, Canada.,Department of Neuroscience, Université de Montréal, Montréal, Québec, H3T 1J4, Canada
| | - Elsa Rossignol
- Research Center & Division of Neurology, Department of Pediatrics, CHU Sainte-Justine, Montréal, Québec, H3T 1C5, Canada.,Department of Neuroscience, Université de Montréal, Montréal, Québec, H3T 1J4, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Québec, H3T 1J4, Canada
| | - Bruce Carleton
- Professor & Division Head, Translational Therapeutics, Department of Pediatrics, University of British-Columbia, Vancouver, British-Columbia, H3T 1J4, Canada.,Director, Pharmaceutical Outcomes Programme, BC Children's Hospital, Vancouver, British-Columbia, V6H 3N1, Canada.,Investigator, BC Children's Hospital Research Institute, Vancouver, British-Columbia, V6H 3N1, Canada
| | - Jean-François Bussières
- Pharmacy Practice Research Unit & Department of Pharmacy, CHU Sainte-Justine, Montréal, Québec, H3T 1C5, Canada.,Clinical Professor, Faculty of Pharmacy, Université de Montréal, Montréal, Québec, H3T 1J4, Canada
| | - Marie-Élaine Métras
- Pharmacy Practice Research Unit & Department of Pharmacy, CHU Sainte-Justine, Montréal, Québec, H3T 1C5, Canada.,Clinical Professor, Faculty of Pharmacy, Université de Montréal, Montréal, Québec, H3T 1J4, Canada
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6
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Bousman CA, Oomen A, Jessel CD, Tampi RR, Forester BP, Eyre HA, Lavretsky H, Müller DJ. Perspectives on the Clinical Use of Pharmacogenetic Testing in Late-Life Mental Healthcare: A Survey of the American Association of Geriatric Psychiatry Membership. Am J Geriatr Psychiatry 2022; 30:560-571. [PMID: 34740522 DOI: 10.1016/j.jagp.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess perspectives on pharmacogenetic (PGx) testing among members of the American Association of Geriatric Psychiatry (AAGP). DESIGN Cross-sectional survey. PARTICIPANTS Members of the AAGP. MEASUREMENTS Anonymous web-based survey consisting of 41 items covering experiences, indications, barriers, facilitators and ethical, legal and social implications for PGx testing. RESULTS A total of 124 surveys were completed (response rate = 13%). Most respondents (60%) had used PGx testing but an equal proportion (58%) was uncertain about the clinical usefulness of PGx testing in late-life mental health. Despite self-reported confidence in the ability to order and interpret PGx testing, 60% of respondents felt there was not enough clinical evidence for them to use PGx testing in their practice. This was compounded by uncertainties related to their ethical obligation and legal liability when interpreting and using (or not using) PGx testing results. Respondents strongly affirmed that clinical and legal guidelines for PGx testing in older adults are needed and would be helpful. CONCLUSION The findings suggest additional PGx research and physician education in late-life mental healthcare settings is required to reconcile uncertainties related to the clinical efficacy and ethico-legal aspects of PGx testing as well as address current knowledge barriers to testing uptake. These efforts would be further facilitated by the development of clinical practice guidelines to ensure equitable access to testing and standardized implementation of PGx-informed prescribing in older adults.
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Affiliation(s)
- Chad A Bousman
- Department of Medical Genetics, University of Calgary (CAB), Calgary, AB, Canada; Department of Psychiatry, University of Calgary (CAB), Calgary, AB, Canada; Department of Physiology & Pharmacology, University of Calgary (CAB), Calgary, AB, Canada; Alberta Children's Hospital Research Institute, University of Calgary (CAB, AO), Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary (CAB, CDJ), Calgary, AB, Canada.
| | - Anita Oomen
- Alberta Children's Hospital Research Institute, University of Calgary (CAB, AO), Calgary, AB, Canada
| | - Chaten D Jessel
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary (CAB, CDJ), Calgary, AB, Canada
| | - Rajesh R Tampi
- Department of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (RRT), Cleveland, OH; Department of Psychiatry, Yale School of Medicine (RRT), New Haven, CT
| | - Brent P Forester
- Division of Geriatric Psychiatry, McLean Hospital (BPF), Belmont, MA; Harvard Medical School (BPF), Boston, MA
| | - Harris A Eyre
- Neuroscience-inspired Policy Initiative, Organisation for Economic Co-Operation and Development (OECD) and PRODEO Institute (HAE), Paris, France; Institute for Mental Health and Physical Health and Clinical Translation (IMPACT), Deakin University (HAE), Geelong, Victoria, Australia; Global Brain Health Institute, University of California, San Francisco and Trinity College Dublin (HAE), Dublin, Ireland; Department of Psychiatry, Baylor College of Medicine (HAE), Houston, TX
| | - Helen Lavretsky
- Department of Psychiatry, Semel Institute for Neuroscience, University of California Los Angeles (HL), Los Angeles, CA
| | - Daniel J Müller
- Department of Psychiatry, University of Toronto (DJM), Toronto, Ontario, Canada; Centre for Addiction and Mental Health, University of Toronto (DJM), Toronto, Ontario, Canada
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7
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Stäuble CK, Jeiziner C, Hersberger KE, Meyer zu Schwabedissen HE, Lampert ML. Pharmacogenetics in Pharmaceutical Care-Piloting an Application-Oriented Blended Learning Concept. PHARMACY 2021; 9:pharmacy9030152. [PMID: 34564559 PMCID: PMC8482083 DOI: 10.3390/pharmacy9030152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/20/2021] [Accepted: 09/01/2021] [Indexed: 12/15/2022] Open
Abstract
To enable application-oriented training of Swiss pharmacists on pharmacogenetic (PGx) testing, an advanced, digital training program was conceptualized based on the Miller's Pyramid framework, using a blended learning approach. The PGx advanced training program included an asynchronous self-study online module, synchronous virtual classroom sessions with lectures and workshops, and a follow-up case study for in-depth applied learning including the analysis of the participants' PGx profile. The evaluation of the training program consisted of (a) an assessment of the participants' development of knowledge, competencies and attitudes towards PGx testing in the pharmacy setting; (b) a satisfaction survey including; (c) questions about their future plans for implementing a PGx service. Twenty-one pharmacists participated in this pilot program. The evaluation showed: (a) a significant improvement of their PGx knowledge (mean score in the knowledge test 75.3% before to 90.3% after training completion) and a significant increase of their self-perceived competencies in applying PGx counselling; (b) a high level of satisfaction with the training program content and the format (at least 79% expressed high/very high agreement with the statements in the questionnaire); (c) a mixed view on whether participants will implement PGx testing as a pharmacy service (indecisive 8; agreed/completely agreed to implement 7/1; disagreed 3 (n = 19)). We consider ongoing education as an important driver for the implementation of PGx in pharmacy practice.
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Affiliation(s)
- Céline K. Stäuble
- Biopharmacy, Department of Pharmaceutical Sciences, University of Basel, 4056 Basel, Switzerland;
- Pharmaceutical Care, Department of Pharmaceutical Sciences, University of Basel, 4001 Basel, Switzerland; (C.J.); (K.E.H.); (M.L.L.)
- Institute of Hospital Pharmacy, Solothurner Spitäler, 4600 Olten, Switzerland
- Correspondence:
| | - Chiara Jeiziner
- Pharmaceutical Care, Department of Pharmaceutical Sciences, University of Basel, 4001 Basel, Switzerland; (C.J.); (K.E.H.); (M.L.L.)
| | - Kurt E. Hersberger
- Pharmaceutical Care, Department of Pharmaceutical Sciences, University of Basel, 4001 Basel, Switzerland; (C.J.); (K.E.H.); (M.L.L.)
| | | | - Markus L. Lampert
- Pharmaceutical Care, Department of Pharmaceutical Sciences, University of Basel, 4001 Basel, Switzerland; (C.J.); (K.E.H.); (M.L.L.)
- Institute of Hospital Pharmacy, Solothurner Spitäler, 4600 Olten, Switzerland
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8
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Subasri M, Barrett D, Sibalija J, Bitacola L, Kim RB. Pharmacogenomic-based personalized medicine: Multistakeholder perspectives on implementational drivers and barriers in the Canadian healthcare system. Clin Transl Sci 2021; 14:2231-2241. [PMID: 34080317 PMCID: PMC8604218 DOI: 10.1111/cts.13083] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/19/2021] [Accepted: 05/02/2021] [Indexed: 01/04/2023] Open
Abstract
Pharmacogenomics (PGx)-based personalized medicine (PM) is increasingly utilized to guide treatment decisions for many drug-disease combinations. Notably, London Health Sciences Centre (LHSC) has pioneered a PGx program that has become a staple for London-based specialists. Although implementational studies have been conducted in other jurisdictions, the Canadian healthcare system is understudied. Herein, the multistakeholder perspectives on implementational drivers and barriers are elucidated. Using a mixed-method qualitative model, key stakeholders, and patients from LHSC's PGx-based PM clinic were interviewed and surveyed, respectively. Interview transcripts were thematically analyzed in a stepwise process of customer profiling, value mapping, and business model canvasing. Value for LHSC located specialist users of PGx was driven by the quick turnaround time, independence of the PGx clinic, and the quality of information. Engagement of external specialists was only limited by access and awareness, whereas other healthcare nonusers were limited by education and applicability. The major determinant of successful adoption at novel sites were institutional champions. Patients valued and approved of the service, expressed a general willingness to pay, but often traveled far to receive genotyping. This paper discusses the critical pillars of education, awareness, advocacy, and efficiency required to address implementation barriers to healthcare service innovation in Canada. Further adoption of PGx practices into Canadian hospitals is an important factor for advancing system-level changes in care delivery, patient experiences, and outcomes. The findings in this paper can help inform efforts to advance clinical PGx practices, but also the potential adoption and implementation of other innovative healthcare service solutions.
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Affiliation(s)
- Mathushan Subasri
- Ivey Business School, University of Western Ontario, London, Ontario, Canada.,London Health Sciences Centre, London, Ontario, Canada
| | - David Barrett
- Ivey Business School, University of Western Ontario, London, Ontario, Canada
| | - Jovana Sibalija
- Ivey Business School, University of Western Ontario, London, Ontario, Canada.,Faculty of Social Science, University of Western Ontario, London, Ontario, Canada
| | | | - Richard B Kim
- Ivey Business School, University of Western Ontario, London, Ontario, Canada.,London Health Sciences Centre, London, Ontario, Canada
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9
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Siamoglou S, Koromina M, Politopoulou K, Samiou CG, Papadopoulou G, Balasopoulou A, Kanavos A, Mitropoulou C, Patrinos GP, Vasileiou K. Attitudes and Awareness Toward Pharmacogenomics and Personalized Medicine Adoption Among Health Sciences Trainees: Experience from Greece and Lessons for Europe. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2021; 25:190-199. [PMID: 33646050 DOI: 10.1089/omi.2020.0230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The increasing incorporation of genomics in clinical practice underscores the need to improve genomics knowledge and familiarity among future health care providers. To this end, it is important to consider both the "push" and the "pull" factors that shape or determine the transition of new personalized medicine (PM) discoveries to clinical practice. One of the pull factors involves the attitudes, values, and education of the user communities such as patients, physicians, and scientists who are poised to use the PM diagnostics. Among the push factors are often health scientists who contribute to PM science and development efforts. Seen in this light, health sciences trainees represent both the push and pull factors, not to mention the next generation of stakeholders and innovation actors who will make PM a reality in mainstream medical practice in the future. Τhis study aimed at investigating and comparing awareness and attitudes (ethical and other) on pharmacogenomics (PGx) and PM adoption among undergraduate students from the school of health sciences and other students. A convenience sample was used in this survey in two groups of students: 205 students from the School of Health Sciences and 141 students from other schools (e.g., biology, computer engineering, and business administration) of the University of Patras, Greece, and mostly at undergraduate education level. We observed that despite the relatively low level of awareness about genetics, PGx, and relevant notions, both groups of students were very optimistic about the genetic testing usefulness and professed their positive anticipations about PGx on disease management. Thus, health sciences students and those in other faculties appeared to be avid proponents of genetics testing and in favor of public endorsement of the concepts of individually tailored medicine. This case study in Greece is one of the first studies on perceptions and attitudes toward PGx testing and PM in Southern Europe. Of importance, the study informs the prospects and challenges on the push and pull factors of PM innovation while offering potential lessons for future PM curriculum needs in health sciences in other countries in Europe.
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Affiliation(s)
- Stavroula Siamoglou
- Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Maria Koromina
- Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
- The Golden Helix Foundation, London, United Kingdom
| | | | | | - Georgia Papadopoulou
- Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Angeliki Balasopoulou
- Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Andreas Kanavos
- 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
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
- Zayed Bin Sultan Center for Health Sciences, United Arab Emirates University, Al Ain, UAE
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