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Shugg T, Tillman EM, Breman AM, Hodge JC, McDonald CA, Ly RC, Rowe EJ, Osei W, Smith TB, Schwartz PH, Callaghan JT, Pratt VM, Lynch S, Eadon MT, Skaar TC. Development of a Multifaceted Program for Pharmacogenetics Adoption at an Academic Medical Center: Practical Considerations and Lessons Learned. Clin Pharmacol Ther 2024; 116:914-931. [PMID: 39169556 PMCID: PMC11452286 DOI: 10.1002/cpt.3402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 07/25/2024] [Indexed: 08/23/2024]
Abstract
In 2019, Indiana University launched the Precision Health Initiative to enhance the institutional adoption of precision medicine, including pharmacogenetics (PGx) implementation, at university-affiliated practice sites across Indiana. The overarching goal of this PGx implementation program was to facilitate the sustainable adoption of genotype-guided prescribing into routine clinical care. To accomplish this goal, we pursued the following specific objectives: (i) to integrate PGx testing into existing healthcare system processes; (ii) to implement drug-gene pairs with high-level evidence and educate providers and pharmacists on established clinical management recommendations; (iii) to engage key stakeholders, including patients to optimize the return of results for PGx testing; (iv) to reduce health disparities through the targeted inclusion of underrepresented populations; (v) and to track third-party reimbursement. This tutorial details our multifaceted PGx implementation program, including descriptions of our interventions, the critical challenges faced, and the major program successes. By describing our experience, we aim to assist other clinical teams in achieving sustainable PGx implementation in their health systems.
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Affiliation(s)
- Tyler Shugg
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Emma M. Tillman
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Amy M. Breman
- Division of Diagnostic Genomics, Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jennelle C. Hodge
- Division of Diagnostic Genomics, Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Christine A. McDonald
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Reynold C. Ly
- Division of Diagnostic Genomics, Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Elizabeth J. Rowe
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Wilberforce Osei
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Tayler B. Smith
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Peter H. Schwartz
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - John T. Callaghan
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Victoria M. Pratt
- Division of Diagnostic Genomics, Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sheryl Lynch
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Michael T. Eadon
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Todd C. Skaar
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Wu JQ, Wang MZ, Bates J, Shaddock RE, Wiisanen K. Pharmacogenomics education strategies in the United States pharmacy school curricula. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:221-230. [PMID: 38281827 DOI: 10.1016/j.cptl.2023.12.029] [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: 08/24/2023] [Revised: 12/11/2023] [Accepted: 12/22/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Clinical pharmacogenomics is an expanding area in healthcare that relies heavily on pharmacists for advocacy and implementation. To support pharmacists' significant roles in clinical pharmacogenomics, pharmacy schools and colleges in the United States (US) have strived to incorporate pharmacogenomics education into their curricula, and various teaching strategies have been employed in recent years to meet pharmacogenomics educational outcomes. The six major strategies reported in the literature are described and compared in this review, which culminates in a proposed longitudinal curriculum design for pharmacogenomics education. METHODS Publications focused on pharmacogenomics education to pharmacy students within the US in the past decade were evaluated and summarized. RESULTS The major education strategies that have been studied are didactic lecture, personal genotyping or personal genomic testing, simulation laboratory activity, interprofessional education, practice-based activity such as clinical rotation, and combinational courses. Strengths and limitations of each teaching strategy are summarized and discussed. IMPLICATIONS Based upon each education strategy's strengths and weaknesses, the authors propose a longitudinal curriculum design to ensure that pharmacogenomics is taught multiple times to pharmacy students with diverse formats and teaching objectives conducive to long-term knowledge retention and practice readiness. Through this longitudinal curriculum design, pharmacy graduates will be well equipped to lead clinical pharmacogenomics in practice.
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Affiliation(s)
- Judy Qiju Wu
- Pharmacy Practice, School of Pharmacy, the University of Kansas, 2001L 2010 Becker Drive, Lawrence, KS 66047, United States.
| | - Michael Zhuo Wang
- Pharmaceutical Chemistry, School of Pharmacy, the University of Kansas, 252 Simons 2093 Constant Ave, Lawrence, KS 66047, United States.
| | - Jessica Bates
- Pharmacy Practice, School of Pharmacy, the University of Kansas, 2001B 2010 Becker Drive, Lawrence, KS 66047, United States.
| | - Rachel E Shaddock
- Clinical Pharmacist Adjunct Faculty, College of Pharmacy, University of Florida, 1225 Center Drive, Gainesville, FL 32610, United States.
| | - Kristin Wiisanen
- Rosalind Franklin University College of Pharmacy, 3333 N Green Bay Rd, North Chicago, IL 60064, United States.
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Soueid R, Michael TJF, Cairns R, Charles KA, Stocker SL. A Scoping Review of Pharmacogenomic Educational Interventions to Improve Knowledge and Confidence. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100668. [PMID: 38331197 DOI: 10.1016/j.ajpe.2024.100668] [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: 10/17/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES Poor knowledge and confidence in pharmacogenomics are key barriers to implementation. Education of future health care professionals is required to enhance appropriate use of pharmacogenomics; however, the optimal education approach is unclear. This systematic scoping review evaluates pharmacogenomic educational interventions to improve knowledge and confidence. FINDINGS A total of 24 studies were included. Most (90%) studies delivered pharmacogenomic education to pharmacy students and consisted of didactic lectures and workshops with case studies. To supplement case studies, self or class aggregated (52%, 12 of 23), mock (43%, 10 of 23) or faculty member provided (4%, 1 of 23) pharmacogenomic data were used in the case scenarios. All studies used quantitative methods, including student assessments and scaled surveys to assess the impact of the educational intervention on knowledge and/or confidence in pharmacogenomics. On average, the educational interventions improved knowledge acquisition by 21%, confidence in pharmacogenomic data interpretation by 37%, confidence in communication of pharmacogenomic information to patients by 41% and to health care professionals by 44%. Improvement in communication with other health care professionals was greater in students involved in interprofessional learning compared to self-pharmacogenomic testing. SUMMARY The measures used to determine the effect of educational interventions on student knowledge and confidence varied. Innovative pedagogy, specifically interactive case-based learning and simulation such as interprofessional learning, enhances the knowledge and confidence of students in pharmacogenomics. Course-embedded self-pharmacogenomic testing may offer a supplementary, interactive component to case-based learning by using real-life reports as the foundation of knowledge and confidence acquisition.
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Affiliation(s)
- Ruby Soueid
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Toni J F Michael
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Rose Cairns
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Kellie A Charles
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Sophie L Stocker
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia; School of Clinical Medicine, Faculty of Medicine and Healthy, University of New South Wales, Sydney, NSW, Australia; Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, Sydney, NSW, Australia.
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Rahma AT, Abdullahi AS, Graziano G, Elbarazi I. The attitude and behaviors of the different spheres of the community of the United Arab Emirates toward the clinical utility and bioethics of secondary genetic findings: a cross-sectional study. Hum Genomics 2023; 17:98. [PMID: 37932866 PMCID: PMC10626730 DOI: 10.1186/s40246-023-00548-7] [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] [Received: 08/03/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023] Open
Abstract
INTRODUCTION Genome sequencing has utility, however, it may reveal secondary findings. While Western bioethicists have been occupied with managing secondary findings, specialists' attention in the Arabic countries has not yet been captured. We aim to explore the attitude of the United Arab Emirates (UAE) population toward secondary findings. METHOD We conducted a cross-sectional study between July and December 2022. The validated questionnaire was administered in English. The questionnaire consists of six sections addressing topics such as demographics, reactions to hypothetical genetic test results, disclosure of mutations to family members, willingness to seek genetic testing, and attitudes toward consanguinity. Chi-squared and Fisher's exact tests were used to investigate associations between categorical variables. RESULTS We had 343 participants of which the majority were female (67%). About four-fifths (82%) were willing to know the secondary findings, whether the condition has treatment or not. The most likely action to take among the participants was to know the secondary findings, so they can make life choices (61%). CONCLUSION These results can construct the framework of the bioethics of disclosing secondary findings in the Arab regions.
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Affiliation(s)
- Azhar T Rahma
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551, UAE.
| | - Aminu S Abdullahi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551, UAE
| | | | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551, UAE
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Omran S, Leong SL, Blebil A, Mohan D, Teoh SL. Effectiveness of pharmacogenomics educational interventions on healthcare professionals and health professions students: A systematic review. Res Social Adm Pharm 2023; 19:1399-1411. [PMID: 37586945 DOI: 10.1016/j.sapharm.2023.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/29/2023] [Accepted: 07/30/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND The field of pharmacogenomics is rapidly advancing, but its adoption and implementation remain slow and lacking. Lack of pharmacogenomics knowledge among healthcare professionals is the most frequently cited barrier to adopting and implementing pharmacogenomics in clinical settings. OBJECTIVES This study aimed to critically evaluate and determine the effectiveness of educational interventions in improving pharmacogenomics knowledge and practice. METHODS Four electronic databases were searched: MEDLINE, EMBASE, CENTRAL, and PsycINFO. Studies on pharmacogenomics educational interventions for health care professionals and students with pre- and post-intervention assessments and results were included. No restrictions were placed on time, language, or educational contexts. The educational outcomes measured include both objective and subjective outcomes. The pharmacogenomics competency domains used to judge educational interventions are based on the competency domains listed by the American Association of Colleges of Pharmacies (AACP). The National Heart, Lung, and Blood Institute of the National Institutes of Health was used for the quality assessment of pre-post studies with no control group and the controlled intervention studies. No meta-analysis was conducted; the data were synthesized qualitatively. The systematic review was reported in accordance with the PRISMA statement. RESULTS Fifty studies were included in this review. All included studies integrated the AACP pharmacogenomics competency domains into their educational interventions. Most of the studies had educational interventions that integrated clinical cases (n = 44; 88%). Knowledge was the most frequently evaluated outcome (n = 34; 68%) and demonstrated significant improvement after the educational intervention that integrated AACP pharmacogenomics competency domains and employed active learning with clinical case inclusion. CONCLUSION This review provided evidence of the effectiveness of educational interventions in improving pharmacogenomics knowledge and practice. Incorporating pharmacogenomics competency domains into education and training, with patient cases for healthcare professionals and students, dramatically improved their pharmacogenomics knowledge, attitudes, and confidence in practice.
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Affiliation(s)
- Safa Omran
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia.
| | - Siew Lian Leong
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Ali Blebil
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Devi Mohan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Siew Li Teoh
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia.
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Haga SB. The Critical Role of Pharmacists in the Clinical Delivery of Pharmacogenetics in the U.S. PHARMACY 2023; 11:144. [PMID: 37736916 PMCID: PMC10514841 DOI: 10.3390/pharmacy11050144] [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: 07/31/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023] Open
Abstract
Since the rebirth of pharmacogenomics (PGx) in the 1990s and 2000s, with new discoveries of genetic variation underlying adverse drug response and new analytical technologies such as sequencing and microarrays, there has been much interest in the clinical application of PGx testing. The early involvement of pharmacists in clinical studies and the establishment of organizations to support the dissemination of information about PGx variants have naturally resulted in leaders in clinical implementation. This paper presents an overview of the evolving role of pharmacists, and discusses potential challenges and future paths, primarily focused in the U.S. Pharmacists have positioned themselves as leaders in clinical PGx testing, and will prepare the next generation to utilize PGx testing in their scope of practice.
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Affiliation(s)
- Susanne B Haga
- Division of General Internal Medicine, Department of Medicine, School of Medicine, Duke University, 101 Science Drive, Durham, NC 27708, USA
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Li C, Su X, Sun Q, Huang Y. Knowledge and attitudes of medical and pharmacy students about pharmacogenomics: a systematic review and meta-analysis. THE PHARMACOGENOMICS JOURNAL 2023; 23:127-133. [PMID: 37142641 DOI: 10.1038/s41397-023-00306-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 05/06/2023]
Abstract
Pharmacogenomics (PGx) is rapidly growing branch of molecular genetics with high potentials to influence therapeutics. This review evaluates knowledge and attitudes of medical and pharmacy students about PGx. A literature search was conducted in electronic databases and studies were selected by following precise eligibility criteria. After quality assessment, studies were reviewed systematically, and meta-analyses of proportions were performed to estimate response rates of students. Fifteen studies (5509 students; 69% [95% confidence interval (CI): 60%, 77%] females) were included. Among students, 28% [95%CI: 12, 46] had adequate PGx knowledge; 65% [95%CI: 55, 75] were willing to have PGx test for their own risk assessment; 78% [95%CI: 71, 84] had intention to incorporate PGx in future practice; and 32% [95%CI: 21, 43] were satisfied with current PGx component of curriculum. Age, advanced year of educational program, and more time spent in PGx education were positively associated with PGx knowledge and positive attitudes.
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Affiliation(s)
- Chen Li
- Department of Pharmacy, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Xiaona Su
- Department of Oncology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Qidi Sun
- Department of Medical & Scientific Research, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Yi Huang
- Biomedical Analysis Center, Army Medical University, Chongqing, 400038, China.
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Farrell CL, Goodbar N, McCaslan M, Moore H, Lee JA, Wu J, Messersmith A. Assessing the pharmacy students' knowledge of genetic counseling with genetic variants that are associated with inherited disease. CURRENTS IN PHARMACY TEACHING & LEARNING 2023; 15:754-760. [PMID: 37507313 DOI: 10.1016/j.cptl.2023.07.006] [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: 02/03/2022] [Revised: 06/02/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND AND PURPOSE To assess pharmacy students' understanding of the importance of genetic counseling through a didactic lecture and active in-class learning exercise in a required pharmacogenomics course. EDUCATIONAL ACTIVITY AND SETTING During the second year, students are enrolled in a two-credit hour pharmacogenomics course which is taught by multiple faculty members from various disciplines. The pharmacy students were taught the clinical importance of genetic results and counseling patients on their individualized reports by a clinical laboratory geneticist and a clinical genetic counselor. After completion of the didactic portion of the class, students practiced genetic counseling skills through role playing with clinical cases involving genetic reports. Students' knowledge of clinical applications of pharmacogenomic data was assessed prior to and following the counseling experience. FINDINGS A paired sample t-test was chosen to analyze the data to determine if there was a difference in mean scores upon the completion of the lecture. There was a statistically significant mean difference between the total scores for the pretest (mean (M) = 37.89, SD = 6.66) and the total scores for the posttest (M = 48.33, SD = 5.24); t(140) = 17.53, P < .001, α = 0.05. The effect size for this analysis (d = 1.74) surpassed Cohen's determination for large effect (d = 0.8). SUMMARY The genetic counseling lecture and activity increased the students' overall awareness of the importance of how sensitive genetic information is reported and delivered to patients.
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Affiliation(s)
- Christopher L Farrell
- Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC, United States.
| | - Nancy Goodbar
- Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, SC, United States
| | - Mandy McCaslan
- Presbyterian College School of Pharmacy, Clinton, SC, United States
| | - Hannah Moore
- Greenwood Genetics Center, Greenwood, SC, United States
| | | | - Jun Wu
- Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC, United States
| | - Amy Messersmith
- Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC, United States
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Slosarek T, Ibing S, Schormair B, Heyne HO, Böttinger EP, Andlauer TFM, Schurmann C. Implementation and evaluation of personal genetic testing as part of genomics analysis courses in German universities. BMC Med Genomics 2023; 16:73. [PMID: 37020303 PMCID: PMC10074719 DOI: 10.1186/s12920-023-01503-0] [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: 11/29/2022] [Accepted: 03/27/2023] [Indexed: 04/07/2023] Open
Abstract
PURPOSE Due to the increasing application of genome analysis and interpretation in medical disciplines, professionals require adequate education. Here, we present the implementation of personal genotyping as an educational tool in two genomics courses targeting Digital Health students at the Hasso Plattner Institute (HPI) and medical students at the Technical University of Munich (TUM). METHODS We compared and evaluated the courses and the students' perceptions on the course setup using questionnaires. RESULTS During the course, students changed their attitudes towards genotyping (HPI: 79% [15 of 19], TUM: 47% [25 of 53]). Predominantly, students became more critical of personal genotyping (HPI: 73% [11 of 15], TUM: 72% [18 of 25]) and most students stated that genetic analyses should not be allowed without genetic counseling (HPI: 79% [15 of 19], TUM: 70% [37 of 53]). Students found the personal genotyping component useful (HPI: 89% [17 of 19], TUM: 92% [49 of 53]) and recommended its inclusion in future courses (HPI: 95% [18 of 19], TUM: 98% [52 of 53]). CONCLUSION Students perceived the personal genotyping component as valuable in the described genomics courses. The implementation described here can serve as an example for future courses in Europe.
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Affiliation(s)
- Tamara Slosarek
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Prof.-Dr.-Helmert-Str. 2-3, 14482, Potsdam, Germany
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Susanne Ibing
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Prof.-Dr.-Helmert-Str. 2-3, 14482, Potsdam, Germany
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Barbara Schormair
- Institute of Neurogenomics, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Institute of Human Genetics, Klinikum Rechts der isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Henrike O Heyne
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Prof.-Dr.-Helmert-Str. 2-3, 14482, Potsdam, Germany
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Erwin P Böttinger
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Prof.-Dr.-Helmert-Str. 2-3, 14482, Potsdam, Germany
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Till F M Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Claudia Schurmann
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Prof.-Dr.-Helmert-Str. 2-3, 14482, Potsdam, Germany.
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
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Guy JW, Stitzlein L, Dudley R, Oestreich JH. Pharmacogenomics elective focused on advanced lab techniques, game-based learning, and business plan development. CURRENTS IN PHARMACY TEACHING & LEARNING 2023; 15:211-217. [PMID: 36959050 DOI: 10.1016/j.cptl.2023.02.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 09/30/2022] [Accepted: 02/24/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND PURPOSE Many medications contain labeling information related to pharmacogenomics. Effective education in this area is critical to ensure that future healthcare professionals are equipped with the skills needed to optimize patient therapy based on genetic testing results. This study focused on a novel elective course designed to educate students in pharmacogenomics. EDUCATIONAL ACTIVITY AND SETTING We developed a one credit hour pharmacogenomics elective course divided into three main content areas. The first section incorporated traditional lecture to review and cover new content not otherwise covered in the curriculum. The second section applied foundational content from the first session through an educational review game and simulated business plan. The third section of the course provided students an overview of laboratory techniques and sample collection procedures. To evaluate the effectiveness of these activities, students provided feedback through course evaluations and completed pre- and posttests on basic pharmacogenomics content. FINDINGS Overall, the course improved knowledge among students, and students provided positive feedback. Students averaged 9% higher on the posttest compared to the pretest (P = .03). Course evaluations trended positive with ratings close to "strongly agree." The most frequent comments stated an appreciation for the interactive components of the course and recommended increasing the elective to two credit hours. SUMMARY Through incorporation of novel lab techniques, game-based learning, and an innovative business plan process, the course increased student knowledge and received positive feedback. These new techniques could serve as a model for other pharmacogenomics training programs.
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Affiliation(s)
- Jason W Guy
- University of Findlay College of Pharmacy, 1000 N Main St, Findlay, OH 45840, United States.
| | - Lea Stitzlein
- Department of Pediatrics Research, The MD Anderson Cancer Center, Houston, TX, United States; The University of Texas MD Anderson Cancer Center, UTHealth Graduate School of Biomedical Sciences, 6767 Bertner Avenue, Houston, TX, United States.
| | - Richard Dudley
- University of Findlay College of Pharmacy, 1000 N Main St, Findlay, OH 45840, United States.
| | - Julie H Oestreich
- University of Findlay College of Pharmacy, 1000 N Main St, Findlay, OH 45840, United States.
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Haga SB, Chung WK, Cubano LA, Curry TB, Empey PE, Ginsburg GS, Mangold K, Miyake CY, Prakash SK, Ramsey LB, Rowley R, Rohrer Vitek CR, Skaar TC, Wynn J, Manolio TA. Development of Competency-based Online Genomic Medicine Training (COGENT). Per Med 2023; 20:55-64. [PMID: 36416152 PMCID: PMC10291206 DOI: 10.2217/pme-2022-0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/17/2022] [Indexed: 11/25/2022]
Abstract
The fields of genetics and genomics have greatly expanded across medicine through the development of new technologies that have revealed genetic contributions to a wide array of traits and diseases. Thus, the development of widely available educational resources for all healthcare providers is essential to ensure the timely and appropriate utilization of genetics and genomics patient care. In 2020, the National Human Genome Research Institute released a call for new proposals to develop accessible, sustainable online education for health providers. This paper describes the efforts of the six teams awarded to reach the goal of providing genetic and genomic training modules that are broadly available for busy clinicians.
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Affiliation(s)
- Susanne B Haga
- Department of Medicine, Duke University School of Medicine, Program in Precision Medicine, 101 Science Drive, Durham, NC 27708, USA
| | - Wendy K Chung
- Department of Pediatrics, Columbia University Irving Medical Center, 1150 St. Nicholas Avenue, Room 620 New York, NY 10032, USA
- Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Luis A Cubano
- National Human Genome Research Institute, Division of Genomic Medicine, 6700B Rockledge Dr, Suite 3100, Bethesda, MD 20892-6908, USA
| | - Timothy B Curry
- Center for Individualized Medicine, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Department of Anesthesia & Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Philip E Empey
- Department of Pharmacy & Therapeutics, Pharmacogenomics Center of Excellence, University of Pittsburgh School of Pharmacy, 9064 Salk Hall, 3501 Terrace Street, Pittsburgh, PA 15261, USA
| | - Geoffrey S Ginsburg
- National Institutes of Health, All of Us Research Program, Bethesda, MD 20892, USA
| | - Kara Mangold
- Center for Individualized Medicine, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Christina Y Miyake
- Department of Pediatrics, Texas Children’s Hospital, 6651 Main Street, Suite E1960.22, Houston, TX 77030, USA
- Department of Molecular Physiology & Biophysics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Siddharth K Prakash
- Department of Internal Medicine, Division of Medical Genetics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Laura B Ramsey
- Divisions of Clinical Pharmacology & Research in Patient Services, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Robb Rowley
- National Human Genome Research Institute, Division of Genomic Medicine, 6700B Rockledge Dr, Suite 3100, Bethesda, MD 20892-6908, USA
| | - Carolyn R Rohrer Vitek
- Center for Individualized Medicine, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Todd C Skaar
- Department of Medicine, Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Julia Wynn
- Department of Pediatrics, Columbia University Irving Medical Center, 1150 St. Nicholas Avenue, Room 620 New York, NY 10032, USA
| | - Teri A Manolio
- National Human Genome Research Institute, Division of Genomic Medicine, 6700B Rockledge Dr, Suite 3100, Bethesda, MD 20892-6908, USA
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12
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Development and Validation of the Minnesota Assessment of Pharmacogenomic Literacy (MAPL). J Pers Med 2022; 12:jpm12091398. [PMID: 36143184 PMCID: PMC9506235 DOI: 10.3390/jpm12091398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/07/2022] [Accepted: 08/21/2022] [Indexed: 02/02/2023] Open
Abstract
Ensuring that patients have an adequate understanding of pharmacogenomic (PGx) test results is a critical component of implementing precision medicine into clinical care. However, no PGx-specific validated literacy assessment has yet been developed. To address this need, we developed and validated the Minnesota Assessment of Pharmacogenomic Literacy (MAPLTM). Foundational work included a scoping review of patient and general public attitudes and experiences with pharmacogenomic testing, three focus groups, readability assessments, and review by experts and members of the general public. This resulted in a 15-item assessment designed to assess knowledge in four domains: underlying concepts, limitations, benefits, and privacy. For validation, 646 participants completed the MAPL as a part of a larger survey about pharmacogenomic research and statewide PGx implementation. Two items were deemed to be “too easy” and dropped. The remaining 13 items were retained in the final MAPL with good internal reliability (Cronbach’s alpha = 0.75). Confirmatory factor analysis validated the four-domain construct of MAPL and suggested good model performance and high internal validity. The estimated coefficient loadings across 13 questions on the corresponding domains are all positive and statistically significant (p < 0.05). The MAPL covers multiple knowledge domains of specific relevance to PGx and is a useful tool for clinical and research settings where quantitative assessment of PGx literacy is of value.
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13
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Bukic J, Rusic D, Leskur D, Perisin AS, Cohadzic T, Kumric M, Bozic J, Modun D. Investigation of Biomedical Students' Attitudes toward Pharmacogenomics and Personalized Medicine: A Cross-Sectional Study. PHARMACY 2022; 10:pharmacy10040073. [PMID: 35893711 PMCID: PMC9326582 DOI: 10.3390/pharmacy10040073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 11/21/2022] Open
Abstract
Background: The utilization of pharmacogenomics in everyday practice has shown several notable benefits. Keeping in mind the rising trend of applicability of pharmacogenomics and personalized medicine, we sought to compare the attitudes of future healthcare workers in different branches of the healthcare system. Methods: The present study was conducted as a questionnaire-based cross-sectional study in October of 2020. Students eligible to participate were all the students of the University of Split School of Medicine enrolled in the academic year 2020/2021. Results: The number of students that participated in the study was 503. Students were most interested in clinical examples of pharmacogenomics (31.4%) and the benefits of pharmacogenomics in clinical practice (36.4%). Furthermore, 72.6% of all students agreed that they should be able, in their future practice, to identify patients that could benefit from genetic testing. Conclusion: At the present time, the lack of education and appropriate clinical guidelines appear to be the major barriers to the clinical application of pharmacogenomics, especially in Croatia. Hence, in order to support health care professionals’ evidence-based therapeutic recommendations with patients’ pharmacogenomic data, universities should offer more pharmacogenomics education in their curricula.
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Affiliation(s)
- Josipa Bukic
- Department of Pharmacy, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia; (J.B.); (D.R.); (D.L.); (A.S.P.)
| | - Doris Rusic
- Department of Pharmacy, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia; (J.B.); (D.R.); (D.L.); (A.S.P.)
| | - Dario Leskur
- Department of Pharmacy, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia; (J.B.); (D.R.); (D.L.); (A.S.P.)
| | - Ana Seselja Perisin
- Department of Pharmacy, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia; (J.B.); (D.R.); (D.L.); (A.S.P.)
| | - Tin Cohadzic
- Department of Pediatric Surgery, University Hospital Centre Split, Spinciceva, 21000 Split, Croatia;
| | - Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia; (M.K.); (J.B.)
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia; (M.K.); (J.B.)
| | - Darko Modun
- Department of Pharmacy, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia; (J.B.); (D.R.); (D.L.); (A.S.P.)
- Correspondence:
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14
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Formea CM, Schultz AJ, Empey PE. Pharmacists Closing Health Disparity Gaps through Pharmacogenomics. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022. [DOI: 10.1002/jac5.1629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Christine M. Formea
- Intermountain Healthcare, Department of Pharmacy Services Salt Lake City Utah
- Intermountain Precision Genomics, Intermountain Healthcare St. George Utah
| | - April J. Schultz
- Sanford Imagenetics, Sanford Health Sioux Falls South Dakota
- Sanford USD School of Medicine University of South Dakota Sioux Falls South Dakota
| | - Philip E. Empey
- School of Pharmacy University of Pittsburgh Pittsburgh Pennsylvania
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15
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Anderson AN, Chan AR, Roman YM. Pharmacogenomics and clinical cultural competency: pathway to overcome the limitations of race. Pharmacogenomics 2022; 23:363-370. [DOI: 10.2217/pgs-2022-0009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Global migration trends are accelerating population admixture. Increasing population diversity met with minority health disparities necessitates thoughtful training of health professional students. Health professional accreditation standards emphasize pharmacogenomics and clinical cultural competency (CCC); however, published studies focus on students’ knowledge in pharmacogenomics alone. This report reviews considerations for integrating CCC into required pharmacogenomic education in pharmacy and other health disciplines. By coupling both topics during didactic training and active learning exercises repeated throughout the existing curriculum, students can become adept at these individualized patient care skills and retain their knowledge into their careers. Moving beyond race as a proxy for healthcare decision-making, the CCC of clinicians coupled with patients’ genetic test results could empower clinicians to address health disparities and facilitate discussions about the role of race in clinical practice. Ultimately, an integrated approach of teaching pharmacogenomics and CCC could dismantle race-norming or race-based clinical practices.
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Affiliation(s)
- Apryl N Anderson
- Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Amy R Chan
- School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Youssef M Roman
- Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA
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16
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Lee AJ, Hui AC, Walker AD, Peshkin BN, Swain SM, Smith DM. Evaluation of a longitudinal pharmacogenomics education on pharmacist knowledge in a multicampus healthcare system. Pharmacogenomics 2022; 23:173-182. [PMID: 35042388 DOI: 10.2217/pgs-2021-0129] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aim: To evaluate the effect of pharmacogenomics (PGx) education for pharmacists. Materials & Methods: Three-part weekly webinar series occurred in 2021. Pharmacists were assessed on their PGx knowledge at baseline and after each webinar. The primary end point was a change in the percent of correct responses between the baseline and week 1 assessment. Secondary end points included change in knowledge at weeks 4-8 and change in self-efficacy. Results: In total, 19 of 58 participants were eligible for the primary analysis, which showed an average improvement of 37% (p < 0.0001). Knowledge remained consistent between week 1 and weeks 4-8. Average self-efficacy increased (p < 0.0001) and was maintained at weeks 4-8. Conclusion: The PGx webinar series resulted in a lasting improvement in PGx knowledge and self-efficacy.
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Affiliation(s)
- Andrew J Lee
- Department of Pharmacy, MedStar Union Memorial Hospital, Baltimore, MD 21218, USA
| | - Adrian C Hui
- Department of Pharmacy, MedStar Union Memorial Hospital, Baltimore, MD 21218, USA
| | | | - Beth N Peshkin
- Georgetown University Medical Center, Washington, DC 20057, USA
| | - Sandra M Swain
- MedStar Health, Columbia, MD 21044, USA.,Georgetown University Medical Center, Washington, DC 20057, USA
| | - D Max Smith
- MedStar Health, Columbia, MD 21044, USA.,Georgetown University Medical Center, Washington, DC 20057, USA
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17
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Barker CIS, Groeneweg G, Maitland-van der Zee AH, Rieder MJ, Hawcutt DB, Hubbard TJ, Swen JJ, Carleton BC. Pharmacogenomic testing in paediatrics: clinical implementation strategies. Br J Clin Pharmacol 2021; 88:4297-4310. [PMID: 34907575 PMCID: PMC9544158 DOI: 10.1111/bcp.15181] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/22/2021] [Accepted: 11/09/2021] [Indexed: 11/27/2022] Open
Abstract
Pharmacogenomics (PGx) relates to the study of genetic factors determining variability in drug response. Implementing PGx testing in paediatric patients can enhance drug safety, helping to improve drug efficacy or reduce the risk of toxicity. Despite its clinical relevance, the implementation of PGx testing in paediatric practice to date has been variable and limited. As with most paediatric pharmacological studies, there are well‐recognised barriers to obtaining high‐quality PGx evidence, particularly when patient numbers may be small, and off‐label or unlicensed prescribing remains widespread. Furthermore, trials enrolling small numbers of children can rarely, in isolation, provide sufficient PGx evidence to change clinical practice, so extrapolation from larger PGx studies in adult patients, where scientifically sound, is essential. This review paper discusses the relevance of PGx to paediatrics and considers implementation strategies from a child health perspective. Examples are provided from Canada, the Netherlands and the UK, with consideration of the different healthcare systems and their distinct approaches to implementation, followed by future recommendations based on these cumulative experiences. Improving the evidence base demonstrating the clinical utility and cost‐effectiveness of paediatric PGx testing will be critical to drive implementation forwards. International, interdisciplinary collaborations will enhance paediatric data collation, interpretation and evidence curation, while also supporting dedicated paediatric PGx educational initiatives. PGx consortia and paediatric clinical research networks will continue to play a central role in the streamlined development of effective PGx implementation strategies to help optimise paediatric pharmacotherapy.
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Affiliation(s)
- Charlotte I S Barker
- Department of Medical & Molecular Genetics, King's College London, London, UK.,Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Gabriella Groeneweg
- Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Pharmaceutical Outcomes Programme, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Anke H Maitland-van der Zee
- Respiratory Medicine/Pediatric Respiratory Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Michael J Rieder
- Departments of Paediatrics, Physiology and Pharmacology and Medicine, Western University, London, Ontario, Canada.,Molecular Medicine Group, Robarts Research Institute, London, Ontario, Canada
| | - Daniel B Hawcutt
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK.,NIHR Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, UK
| | - Tim J Hubbard
- Department of Medical & Molecular Genetics, King's College London, London, UK.,Genomics England, London, UK
| | - Jesse J Swen
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Network for Personalized Therapeutics, Leiden, The Netherlands
| | - Bruce C Carleton
- Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Pharmaceutical Outcomes Programme, BC Children's Hospital, Vancouver, British Columbia, Canada.,BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
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18
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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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19
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Grace C, Larriva MM, Steiner HE, Marupuru S, Campbell PJ, Patterson H, Cropp CD, Quinn D, Klimecki W, Nix DE, Warholak T, Karnes JH. Efficacy of personal pharmacogenomic testing as an educational tool in the pharmacy curriculum: A nonblinded, randomized controlled trial. Clin Transl Sci 2021; 14:2532-2543. [PMID: 34431601 PMCID: PMC8604226 DOI: 10.1111/cts.13121] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/21/2021] [Accepted: 06/29/2021] [Indexed: 11/11/2022] Open
Abstract
Personal genomic educational testing (PGET) has been suggested as a strategy to improve student learning for pharmacogenomics (PGx), but no randomized studies have evaluated PGET’s educational benefit. We investigated the effect of PGET on student knowledge, comfort, and attitudes related to PGx in a nonblinded, randomized controlled trial. Consenting participants were randomized to receive PGET or no PGET (NPGET) during 4 subsequent years of a PGx course. All participants completed a pre‐survey and post‐survey designed to assess (1) PGx knowledge, (2) comfort with PGx patient education and clinical skills, and (3) attitudes toward PGx. Instructors were blinded to PGET assignment. The Wilcoxon Rank Sum test was used to compare pre‐survey and post‐survey PGx knowledge, comfort, and attitudes. No differences in baseline characteristics were observed between PGET (n = 117) and NPGET (n = 116) participants. Among all participants, significant improvement was observed in PGx knowledge (mean 57% vs. 39% correct responses; p < 0.001) with similar results for student comfort and attitudes. Change in pre/post‐PGx knowledge, comfort, and attitudes were not significantly different between PGET and NPGET groups (mean 19.5% vs. 16.7% knowledge improvement, respectively; p = 0.41). Similar results were observed for PGET participants carrying a highly actionable PGx variant versus PGET participants without an actionable variant. Significant improvement in Likert scale responses were observed in PGET versus NPGET for questions that assessed student engagement (p = 0.020) and reinforcement of course concepts (p = 0.006). Although some evidence of improved engagement and participation was observed, the results of this study suggest that PGET does not directly improve student PGx knowledge, comfort, and attitudes.
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Affiliation(s)
- Chloe Grace
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - Marti M Larriva
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA.,Arizona Oncology, Tucson, Arizona, USA
| | - Heidi E Steiner
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - Srujitha Marupuru
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - Patrick J Campbell
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - Hayley Patterson
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - Cheryl D Cropp
- Department of Pharmaceutical, Social and Administrative Sciences, Samford University McWhorter School of Pharmacy, Birmingham, Alabama, USA
| | - Dorothy Quinn
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA.,Department of Obstetrics and Gynecology, University of Arizona College of Medicine-Tucson, Tucson, Arizona, USA
| | - Walter Klimecki
- College of Veterinary Medicine, University of Arizona, Tucson, Arizona, USA.,Department of Pharmacology and Toxicology, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - David E Nix
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - Terri Warholak
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - Jason H Karnes
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA.,Department of Pharmacology and Toxicology, University of Arizona College of Pharmacy, Tucson, Arizona, USA.,Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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20
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Adesta F, Mahendra C, Junusmin KI, Rajah AMS, Goh S, Sani L, Chan A, Irwanto A. Pharmacogenomics Implementation Training Improves Self-Efficacy and Competency to Drive Adoption in Clinical Practice. Front Pharmacol 2021; 12:684907. [PMID: 34262455 PMCID: PMC8273230 DOI: 10.3389/fphar.2021.684907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Administration of pharmacogenomics (PGx) testing in clinical practice has been suboptimal, presumably due to lack of PGx education. Here, we aim to evaluate the standpoint of PGx testing among a diverse group of healthcare professionals (HCPs) through conducting surveys before and after training. Materials and Methods: Training modules were designed to cover three key learning objectives and deployed in five sections. A pre- and post-training survey questionnaire was used to evaluate participants' self-assessments on employing PGx in clinical practice. Results and Conclusion: Out of all enrollments, 102 survey responses were collected. Overall, respondents agree on the benefits of PGx testing, but have inadequate self-efficacy and competency in utilizing PGx data. Our results show that a 90 min long training significantly improves these, and could lead to greater anticipation of PGx adoption.
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Affiliation(s)
| | | | | | | | - Sharon Goh
- Nalagenetics Pte Ltd, Singapore, Singapore
| | | | - Alexandre Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, Irvine, CA, United States
| | - Astrid Irwanto
- Nalagenetics Pte Ltd, Singapore, Singapore.,Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
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21
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Muflih S, Alshogran OY, Al-Azzam S, Al-Taani G, Khader YS. Physicians' Knowledge and Attitudes Regarding Point-of-Care Pharmacogenetic Testing: A Hospital-Based Cross-Sectional Study. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2021; 14:655-665. [PMID: 34103970 PMCID: PMC8179816 DOI: 10.2147/pgpm.s307694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 04/26/2021] [Indexed: 12/03/2022]
Abstract
Introduction Pharmacogenetic testing (PGx) is a diagnostic technique used by physicians to determine the possible reactions of patients to drug treatment on the basis of their genetic makeup. The aim of this study was to determine the impact of physicians’ awareness, attitudes, and sociodemographics on the adoption of point-of-care (POC) PGx testing as a diagnostic method, as well as the impact of their knowledge, attitudes, and sociodemographics on its adoption. Methods A cross-sectional survey of 200 physicians and medical trainees working at the Clinics of King Abdullah University Hospital in Jordan was performed. Data on sociodemographics, knowledge and attitudes concerning PGx testing, genetic information sources, and barriers to POC-PGx testing adoption were gathered. Results Participants’ perceived knowledge of the role of PGx testing in therapeutic decision-making was rated as “Excellent” (1.9%), “Very Good” (19.4%), “Good” (34.4%), “Fair” (32.5%), and “Poor” (11.9%). Physicians’ actual knowledge of PGx testing was adequate (mean=3.56 out of 7, SD=1.2), but their attitudes were generally favorable (mean=3.64 out of 5.00, SD=0.52). According to Rogers’ theory, many variables (eg, perceived need, relative advantage, compatibility) had a significant impact on physicians’ willingness to endorse POC-PGx testing. Discussion The majority of physicians stated that they were unaware of PGx testing. Physicians’ perceived knowledge of POC-PGx testing, however, was higher than those who participated in other studies. Participants were optimistic about the future benefits of PGx testing in prescribing effective medications and reducing potential side effects, which were consistent with previous studies. Physicians’ willingness to accept and implement POC-PGx testing was hampered by a lack of PGx expertise, as well as concerns about patient confidentiality, employability, and insurability. More training and genetic courses are needed, according to the majority of participants.
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Affiliation(s)
- Suhaib Muflih
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Osama Y Alshogran
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Sayer Al-Azzam
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Ghaith Al-Taani
- Department of Pharmacy Practice, Yarmouk University, Irbid, Jordan
| | - Yousef S Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, 22110, Jordan
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22
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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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23
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Russell LE, Zhou Y, Almousa AA, Sodhi JK, Nwabufo CK, Lauschke VM. Pharmacogenomics in the era of next generation sequencing - from byte to bedside. Drug Metab Rev 2021; 53:253-278. [PMID: 33820459 DOI: 10.1080/03602532.2021.1909613] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Pharmacogenetic research has resulted in the identification of a multitude of genetic variants that impact drug response or toxicity. These polymorphisms are mostly common and have been included as actionable information in the labels of numerous drugs. In addition to common variants, recent advances in Next Generation Sequencing (NGS) technologies have resulted in the identification of a plethora of rare and population-specific pharmacogenetic variations with unclear functional consequences that are not accessible by conventional forward genetics strategies. In this review, we discuss how comprehensive sequencing information can be translated into personalized pharmacogenomic advice in the age of NGS. Specifically, we provide an update of the functional impacts of rare pharmacogenetic variability and how this information can be leveraged to improve pharmacogenetic guidance. Furthermore, we critically discuss the current status of implementation of pharmacogenetic testing across drug development and layers of care. We identify major gaps and provide perspectives on how these can be minimized to optimize the utilization of NGS data for personalized clinical decision-support.
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Affiliation(s)
| | - Yitian Zhou
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Ahmed A Almousa
- Department of Pharmacy, London Health Sciences Center, Victoria Hospital, London, ON, Canada
| | - Jasleen K Sodhi
- Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, University of California San Francisco, San Francisco, CA, USA.,Department of Drug Metabolism and Pharmacokinetics, Plexxikon, Inc., Berkeley, CA, USA
| | | | - Volker M Lauschke
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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24
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Rahma AT, Ahmed LA, Elsheik M, Elbarazi I, Ali BR, Patrinos GP, Al-Maskari F. Mapping the Educational Environment of Genomics and Pharmacogenomics in the United Arab Emirates: A Mixed-Methods Triangulated Design. OMICS : A JOURNAL OF INTEGRATIVE BIOLOGY 2021; 25:285-293. [PMID: 33904793 DOI: 10.1089/omi.2021.0029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pharmacogenomics (PGx) education is crucial to support the effective delivery of PGx services in any health care system. We mapped the current educational environment of genomics and PGx in the United Arab Emirates (UAE) and assessed the readiness of the accredited higher education system to move forward with the implementation of PGx in the country. We employed a mixed-methods triangulated approach to map the PGx educational environment in UAE. We used two qualitative methods and one quantitative method. University curricula inspection, interviews, and questionnaires were the main resources of data. PGx was taught in 6 out of 21 accredited universities, but only for pharmacy majors. Only three out of six PGx courses were stand-alone. Majority of academia exhibited positive attitudes toward the availability and accessibility of genetic testing, with 89% agreeing that the government should invest more money into its development. Interviews with academics and, importantly, the commissioners who oversee the accreditation process of universities in UAE revealed recurrent themes that included recognizing the importance of genomic medicine and PGx and called for translational and implementational research, including recruitment of experts in the field. We recommend, as supported by our findings in this study, the creation of standardized curriculum of genomics and PGx for each health science field, using the blended teaching approach, and benchmarking internationally accredited universities to foster international collaboration and improve the education and practice of genomics in the clinic and public health systems. An 11-item genomics and PGx strategy is presented herein. Finally, the mixed-methods study design employed in this research may also serve as a model conceptual frame for other science education mapping efforts at country or multi-institutional scales in the future.
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Affiliation(s)
- Azhar T Rahma
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Luai A Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mahanna Elsheik
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Bassam R Ali
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - George P Patrinos
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Fatma Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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25
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Burghardt KJ, Ward KM, Howlett BH, Burghardt PR. Personal genotyping and student outcomes in genetic and pharmacogenetic teaching: a systematic review and meta-analysis. Pharmacogenomics 2021; 22:423-433. [PMID: 33858193 DOI: 10.2217/pgs-2021-0004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Teaching of genetics and pharmacogenetics with personal genotyping (PGT) is becoming commonplace. We aimed to perform a systematic review and meta-analysis to understand the effects of PGT on student outcomes. Methods: A systematic review was performed on studies that reported the effects of PGT on student attitudes, perceptions or knowledge. Extracted data were summarized qualitatively and when possible, quantitatively. Results: Student PGT has a positive effect on student attitude and perceptions survey responses in studies without a control group (p = 0.009) and in studies with a control group (p = 0.025). Knowledge increased after the use of PGT (p < 0.001) in studies without a control group. Conclusion: The findings here suggest that perceptions, attitudes and knowledge increase with PGT in the classroom.
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Arwood MJ, McDonough CW, Cavallari LH, Elsey AR, Frye RF, Gong Y, Langaee T, Johnson JA, Wiisanen K. Evaluating an interactive teaching approach with personal genotyping to provide pharmacy students with a knowledge base for clinical pharmacogenetics. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Meghan J. Arwood
- Department of Pharmacotherapy and Translational Research University of Florida College of Pharmacy, University of Florida Gainesville Florida USA
- University of Florida Center for Pharmacogenomics and Precision Medicine Gainesville Florida USA
| | - Caitrin W. McDonough
- Department of Pharmacotherapy and Translational Research University of Florida College of Pharmacy, University of Florida Gainesville Florida USA
- University of Florida Center for Pharmacogenomics and Precision Medicine Gainesville Florida USA
| | - Larisa H. Cavallari
- Department of Pharmacotherapy and Translational Research University of Florida College of Pharmacy, University of Florida Gainesville Florida USA
- University of Florida Center for Pharmacogenomics and Precision Medicine Gainesville Florida USA
- University of Florida Clinical and Translational Science Institute Gainesville Florida USA
| | - Amanda R. Elsey
- Department of Pharmacotherapy and Translational Research University of Florida College of Pharmacy, University of Florida Gainesville Florida USA
- University of Florida Clinical and Translational Science Institute Gainesville Florida USA
| | - Reginald F. Frye
- Department of Pharmacotherapy and Translational Research University of Florida College of Pharmacy, University of Florida Gainesville Florida USA
- University of Florida Center for Pharmacogenomics and Precision Medicine Gainesville Florida USA
| | - Yan Gong
- Department of Pharmacotherapy and Translational Research University of Florida College of Pharmacy, University of Florida Gainesville Florida USA
- University of Florida Center for Pharmacogenomics and Precision Medicine Gainesville Florida USA
| | - Taimour Langaee
- Department of Pharmacotherapy and Translational Research University of Florida College of Pharmacy, University of Florida Gainesville Florida USA
- University of Florida Center for Pharmacogenomics and Precision Medicine Gainesville Florida USA
| | - Julie A. Johnson
- Department of Pharmacotherapy and Translational Research University of Florida College of Pharmacy, University of Florida Gainesville Florida USA
- University of Florida Center for Pharmacogenomics and Precision Medicine Gainesville Florida USA
- University of Florida College of Medicine Gainesville Florida USA
| | - Kristin Wiisanen
- Department of Pharmacotherapy and Translational Research University of Florida College of Pharmacy, University of Florida Gainesville Florida USA
- University of Florida Center for Pharmacogenomics and Precision Medicine Gainesville Florida USA
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Cicali EJ, Cook KJ, Arwood MJ, Elchynski A, Wiisanen K. Competency‐based clinical pharmacogenomics activities during an advanced pharmacy practice experience. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Emily J. Cicali
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine University of Florida College of Pharmacy Gainesville Florida USA
| | - Kelsey J. Cook
- Department of Pharmacotherapy and Translational Research University of Florida College of Pharmacy Jacksonville Florida USA
| | - Meghan J. Arwood
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine University of Florida College of Pharmacy Gainesville Florida USA
| | - Amanda Elchynski
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine University of Florida College of Pharmacy Gainesville Florida USA
| | - Kristin Wiisanen
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine University of Florida College of Pharmacy Gainesville Florida USA
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Guy JW, Patel I, Oestreich JH. Clinical Application and Educational Training for Pharmacogenomics. PHARMACY 2020; 8:pharmacy8030163. [PMID: 32899212 PMCID: PMC7558792 DOI: 10.3390/pharmacy8030163] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 12/28/2022] Open
Abstract
Pharmacogenomics—defined as the study of how genes affect a person’s response to drugs—is growing in importance for clinical care. Many medications have evidence and drug labeling related to pharmacogenomics and patient care. New evidence supports the use of pharmacogenomics in clinical settings, and genetic testing may optimize medication selection and dosing. Despite these advantages, the integration of pharmacogenomics into clinical decisions remains variable and challenging in certain practice settings. To ensure consistent application across settings, sufficient education amongst current and future healthcare providers is necessary to further integrate pharmacogenomics into routine clinical practice. This review highlights current evidence supporting clinical application of medications with pharmacogenomic labeling. The secondary objective is to review current strategies for educating health professionals and student trainees. One national organization predicts that most regions in the United States will soon contain at least one healthcare system capable of applying pharmacogenomic information. Applying genotype-guided dosing to several FDA-approved medications may help produce beneficial changes in patient outcomes. Identifying best practices for educating health care professionals and trainees remains vitally important for continuing growth of pharmacogenomic services. As pharmacogenomics continues to expand into more areas of healthcare, current and future practitioners must pursue and maintain competence in pharmacogenomics to ensure better outcomes for patients.
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Affiliation(s)
- Jason W. Guy
- Department of Pharmacy Practice, College of Pharmacy, University of Findlay, Findlay, OH 45840, USA
- Correspondence:
| | - Isha Patel
- Department of Pharmacy Practice, Administration and Research, Marshall University School of Pharmacy, Huntington, WV 25755, USA;
| | - Julie H. Oestreich
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Findlay, Findlay, OH 45840, USA;
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29
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Roman YM, Dixon DL, Salgado TM, Price ET, Zimmerman KM, Sargent L, Slattum PW. Challenges in pharmacotherapy for older adults: a framework for pharmacogenomics implementation. Pharmacogenomics 2020; 21:627-635. [PMID: 32425117 DOI: 10.2217/pgs-2019-0198] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Older adults are at high risk for inappropriate prescribing, developing polypharmacy, adverse drug events and poor treatment outcomes due to multimorbidity and geriatric syndromes. Pharmacogenomics could allow healthcare professionals to provide optimal patient care while minimizing the risk of adverse drug events and simplifying complex medication regimens. The implementation of pharmacogenomics in geriatrics medicine requires a broad multilayered bottom-up approach. These include curriculum redesign, rethinking experiential education and patient and provider education. There are barriers associated with adopting pharmacogenomics into clinical practice. These barriers may include economic factors, workflow and informatics support. However, addressing these barriers primarily requires creating a culture of innovative practices in patient care, ongoing interprofessional continuing education and an interdisciplinary approach for patient care.
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Affiliation(s)
- Youssef M Roman
- Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Dave L Dixon
- Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA.,Center for Pharmacy Practice Innovation, Richmond, VA 23298, USA
| | - Teresa M Salgado
- Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA.,Center for Pharmacy Practice Innovation, Richmond, VA 23298, USA
| | - Elvin T Price
- Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA.,Institute for Inclusion, Inquiry & Innovation (iCubed): Health & Wellness in Aging Populations Core, Richmond, VA 23298, USA
| | - Kristin M Zimmerman
- Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA.,Center for Pharmacy Practice Innovation, Richmond, VA 23298, USA
| | - Lana Sargent
- School of Nursing, Virginia Commonwealth University, Richmond, VA 232398, USA
| | - Patricia W Slattum
- Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA
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30
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Rashkin MD, Bowes J, Dunaway K, Dhaliwal J, Loomis E, Riffle S, Washington NL, Ziegler C, Lu J, Levin E. Genetic counseling, 2030: An on-demand service tailored to the needs of a price conscious, genetically literate, and busy world. J Genet Couns 2020; 28:456-465. [PMID: 30964579 DOI: 10.1002/jgc4.1123] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 03/06/2019] [Accepted: 03/08/2019] [Indexed: 12/20/2022]
Abstract
The practice of genetic counseling is going to be impacted by the public's expectation that goods, services, information, and experiences happen on demand, wherever and whenever people want them. Building from trends that are currently taking shape, this article looks just over a decade into the future-to 2030-to provide a description of how the field of genetics and genetic counseling will be changed, as well as advice for genetic counselors for how to prepare. We build from the prediction that a large portion of the general public will have access to their digitized whole genome sequence anytime, any place, on any device. We focus on five topics downstream of this prediction: public health, personal autonomy, polygenic scores (PGS), evolving clinical practices, and genetic privacy.
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Affiliation(s)
| | | | | | | | | | | | | | | | - James Lu
- Helix Opco, LLC, San Carlos, California
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31
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Johnson A, Broughton S, Aponte-Soto L, Watson K, Pinto CDG, Empey P, Reis S, Winn R, Massart M. Participatory Genomic Testing Can Effectively Disseminate Cardiovascular Pharmacogenomics Concepts within Federally Qualified Health Centers: A Feasibility Study. Ethn Dis 2020; 30:167-176. [PMID: 32269458 DOI: 10.18865/ed.30.s1.167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective We assessed feasibility of an educational program designed to enhance stakeholder knowledge and perceptions of pharmacogenomics at a federally qualified health center (FQHC). Design FQHCs have a rich history of providing care to the underserved, but often are not represented by studies evaluating cutting-edge concepts. We used a novel educational platform to provide participatory genomic testing and classroom education. We assessed participant knowledge and perceptions using questionnaires between May and July 2018. Setting We partnered with a FQHC affiliated with an academic medical center in Chicago. Participants Using convenience sampling, we recruited 20 providers and 10 community members for a feasibility study. Providers included physicians, physician extenders, community health workers, and patient health navigators. Community members were patients, supporters, and/or FQHC advisory board members. Intervention Participants had the option to undergo personal genomic testing. Online educational modules included basic genetics, cardiovascular pharmacogenomics, and personalized medicine. Education concluded in a 2-hour live course with case-based discussions. Main Outcome Measures Our main outcome was testing pilot feasibility. Baseline knowledge and perceptions were compared with post-intervention assessments using descriptive statistics, t tests (or Wilcoxon rank-sum) for continuous variables and chi-squared (or Fisher's exact) for categorical variables. Results We found that attitudes toward the intervention were positive and remained so after intervention. Our intervention was both feasible and acceptable. Genomics knowledge increased for nearly all participants. Conclusions We have determined that a pharmacogenomics educational program tailored for an underrepresented community is feasible and acceptable. Outcomes will advise methodology for larger implementation studies.
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Affiliation(s)
| | | | - Lisa Aponte-Soto
- University of Illinois Cancer Center at University of Illinois at Chicago, IL.,University of Illinois Hospital and Health Services System Mile Square Health Center, Chicago, IL
| | - Karriem Watson
- University of Illinois Cancer Center at University of Illinois at Chicago, IL.,University of Illinois Hospital and Health Services System Mile Square Health Center, Chicago, IL
| | - Carla Da Goia Pinto
- University of Illinois Cancer Center at University of Illinois at Chicago, IL.,University of Illinois Hospital and Health Services System Mile Square Health Center, Chicago, IL
| | | | | | - Robert Winn
- University of Illinois Cancer Center at University of Illinois at Chicago, IL.,University of Illinois Hospital and Health Services System Mile Square Health Center, Chicago, IL
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Ilori TO, Viera E, Wilson J, Moreno F, Menon U, Ehiri J, Peterson R, Vemulapalli T, StimsonRiahi SC, Rosales C, Calhoun E, Sokan A, Karnes JH, Reiman E, Ojo A, Theodorou A, Ojo T. Approach to High Volume Enrollment in Clinical Research: Experiences from an All of Us Research Program Site. Clin Transl Sci 2020; 13:685-692. [PMID: 32004412 PMCID: PMC7359931 DOI: 10.1111/cts.12759] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/20/2020] [Indexed: 11/29/2022] Open
Abstract
Clinical trials and cohort studies are required to meet target recruitment of study participants within stipulated timelines, especially when the priority is to include populations traditionally unrepresented in biomedical research. By the third quarter of 2019, the University of Arizona‐Banner Health Provider Organization (UA‐Banner HPO) has enrolled > 30,000 core participants into the All of Us Research Program (AoURP), the research cohort of the Precision Medicine Initiative. The majority of enrolled participants meet the criteria for individuals under‐represented in biomedical research. The enrollment goals were calculated based on a target of 20,000 as set by the National Institutes of Health and our health provider organization achieved enrollment numbers between 17% and 86% above the targeted daily enrollment. We evaluated enrollment methods and challenges to enrollments encountered by the UA‐Banner Health Provider Organization into the AoURP. Challenges to enrollment centered around the need for high‐touch engagement methods, time investment necessary for stakeholder inclusion, and the use of purely digital enrollment methods especially in populations under‐represented in biomedical research. These challenges occurred at the level of the individual, provider, institutions, and community, and cumulatively impacted participant enrollment. Successful strategies for engagement and enrollment leveraged provider partners as advocates for the program. For high‐volume enrollment in clinical research, it is important to engage leaders in the healthcare setting, patient providers, and tailor engagement and enrollment to potential participant needs. We emphasize the need for precision engagement and enrollment methods tailored to individual needs.
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Affiliation(s)
- Titilayo O Ilori
- Renal Section, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Emma Viera
- Division of Public Health Practice and Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Jillian Wilson
- Department of Internal Medicine, Kansas University Medical Center, Kansas City, Kansas, USA
| | - Francisco Moreno
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Usha Menon
- College of Nursing, University of South Florida, Tampa, Florida, USA
| | - John Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | | | - Tejo Vemulapalli
- Department of Medicine, College of Medicine Tucson, University of Arizona, Tucson, Arizona, USA
| | - Sara C StimsonRiahi
- Department of Medicine, College of Medicine Phoenix, University of Arizona, Tucson, Arizona, USA
| | - Cecilia Rosales
- Division of Public Health Practice and Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Elizabeth Calhoun
- Division of Community, Environment, and Policy of the UA Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Amanda Sokan
- Division of Public Health Practice and Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Jason H Karnes
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, Arizona, USA
| | - Eric Reiman
- Banner Alzheimer's Institute, Phoenix, Arizona, USA
| | - Akinlolu Ojo
- Kansas University Medical Center, Kansas City, Kansas, USA
| | - Andreas Theodorou
- Department of Pediatrics, University of Arizona, Tucson, Arizona, USA.,Banner University Medical Group, Tucson, Arizona, USA
| | - Tammy Ojo
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Kansas University Medical Center, Kansas City, Kansas, USA
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Meloche M, Kwon HJ, Letarte N, Bussières JF, Vadnais B, Hurlimann T, Lavoie A, Beauchesne MF, de Denus S. Opinion, experience and educational preferences concerning pharmacogenomics: an exploratory study of Quebec pharmacists. Pharmacogenomics 2020; 21:235-245. [DOI: 10.2217/pgs-2019-0135] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: To evaluate the current opinion, experience and educational preferences of pharmacists in Quebec concerning pharmacogenomics. Method: A web-based survey containing 25 questions was sent to all Quebec pharmacists. Results: Most pharmacists were willing to advise patients (81%) and physicians (84%) on treatment choices based on pharmacogenomic test results after proper training. Only 31% had been previously exposed to pharmacogenomic test results, and 91% were favorable to pharmacogenomics training, with e-learning through interactive video sessions (69%). The preferred training session length was between 1 and 3 h (59%). Hospital pharmacists were more often exposed to pharmacogenomic tests (p < 0.0001) and more frequently advised patients on treatment choices (p < 0.001) than community pharmacists. Conclusion: Pharmacists remain favorable toward pharmacogenomics, but its use in clinical practice stays limited. Identifying the educational preferences of pharmacists may help in the development of educational programs to help them integrate pharmacogenomics in their clinical practice.
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Affiliation(s)
- Maxime Meloche
- Faculty of Pharmacy, Université de Montréal, Montreal, Canada
- Montreal Heart Institute, Montreal, Canada
| | - Hyuk J Kwon
- Faculty of Pharmacy, Université de Montréal, Montreal, Canada
| | - Nathalie Letarte
- Faculty of Pharmacy, Université de Montréal, Montreal, Canada
- Department of Pharmacy, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
| | - Jean-François Bussières
- Faculty of Pharmacy, Université de Montréal, Montreal, Canada
- Department of Pharmacy, Sainte-Justine University Hospital Center, Montreal, Canada
| | - Barbara Vadnais
- Faculty of Pharmacy, Université de Montréal, Montreal, Canada
- Department of Pharmacy, Hôpital Maisonneuve-Rosemont, Montreal, Canada
| | - Thierry Hurlimann
- Department of Social & Preventive Medicine, Bioethics Programs, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Annie Lavoie
- Department of Pharmacy, Sainte-Justine University Hospital Center, Montreal, Canada
| | - Marie-France Beauchesne
- Faculty of Pharmacy, Université de Montréal, Montreal, Canada
- Research Center, Centre Intégré Universitaire de Santé et de Services Sociaux de l’Estrie-Centre Hospitalier Universitaire de Sherbrooke, Installations Hôtel-Dieu et Fleurimont, Sherbrooke, Canada
| | - Simon de Denus
- Faculty of Pharmacy, Université de Montréal, Montreal, Canada
- Montreal Heart Institute, Montreal, Canada
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Wang YT, Merl MY, Yang J, Zhu ZX, Li GH. Opportunities for pharmacists to integrate pharmacogenomics into clinical practice. THE PHARMACOGENOMICS JOURNAL 2019; 20:169-178. [PMID: 31796890 DOI: 10.1038/s41397-019-0119-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 11/09/2022]
Abstract
Many medical centers in the United States have implemented pharmacogenomics (PGx) programs to integrate PGx into clinical practice. The roles of pharmacists in optimizing medication use based on genetic testing results are emergently evolving. A literature search was conducted to assess pharmacists' roles in pharmacogenetics/pharmacogenomics or precision/personalized medicine programs. Fifteen PGx pharmacy practice models implemented in eleven hospitals and one community pharmacy in the U.S. were selected for evaluation. Pharmacists perform results interpretation, genotype-guided medication selection and adjustment, medication acquisition, adverse reactions monitoring, and patient education. Institutions that are interested in implementing a PGx program should plan the strategies to overcome the challenges, such as educational knowledge gaps, informatics, and reimbursement issues. Strong institutional support, well-defined goals, standardized procedures, and strategies to educate clinicians and patients are the prerequisites to comprehensively deliver genomic data for individualized drug therapy.
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Affiliation(s)
- Yan-Ting Wang
- Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Man Yee Merl
- Department of Pharmacy, Yale New Haven Hospital, New Haven, CT, 06510, USA.
| | - Jun Yang
- Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Zhi-Xiang Zhu
- Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Guo-Hui Li
- Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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Linderman MD, McElroy L, Chang L. MySeq: privacy-protecting browser-based personal Genome analysis for genomics education and exploration. BMC Med Genomics 2019; 12:172. [PMID: 31775760 PMCID: PMC6882182 DOI: 10.1186/s12920-019-0615-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 11/08/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The complexity of genome informatics is a recurring challenge for genome exploration and analysis by students and other non-experts. This complexity creates a barrier to wider implementation of experiential genomics education, even in settings with substantial computational resources and expertise. Reducing the need for specialized software tools will increase access to hands-on genomics pedagogy. RESULTS MySeq is a React.js single-page web application for privacy-protecting interactive personal genome analysis. All analyses are performed entirely in the user's web browser eliminating the need to install and use specialized software tools or to upload sensitive data to an external web service. MySeq leverages Tabix-indexing to efficiently query whole genome-scale variant call format (VCF) files stored locally or available remotely via HTTP(s) without loading the entire file. MySeq currently implements variant querying and annotation, physical trait prediction, pharmacogenomic, polygenic disease risk and ancestry analyses to provide representative pedagogical examples; and can be readily extended with new analysis or visualization components. CONCLUSIONS MySeq supports multiple pedagogical approaches including independent exploration and interactive online tutorials. MySeq has been successfully employed in an undergraduate human genome analysis course where it reduced the barriers-to-entry for hands-on human genome analysis.
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Affiliation(s)
| | - Leo McElroy
- Department of Computer Science, Middlebury College, Middlebury, VT USA
| | - Laura Chang
- Department of Computer Science, Middlebury College, Middlebury, VT USA
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36
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Hansen J, Stadler D. Nutritional Genomics: Exploration of Personal Genetic Testing in the Classroom. J Acad Nutr Diet 2019; 119:1613-1617. [DOI: 10.1016/j.jand.2019.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Indexed: 01/08/2023]
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37
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Weinstein S, Carroll JC, Jukic S, Mcgivney MS, Klatt P. Perspectives of a pharmacist‐run pharmacogenomic service for depression in interdisciplinary family medicine practices. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2019. [DOI: 10.1002/jac5.1175] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Sara Weinstein
- Ernest Mario School of Pharmacy, Rutgers The State University of New Jersey Piscataway USA
| | - Joni C. Carroll
- University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania
| | - Sejla Jukic
- University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania
| | | | - Patricia Klatt
- Ernest Mario School of Pharmacy, Rutgers The State University of New Jersey Piscataway USA
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Suzuki O, Dong OM, Howard RM, Wiltshire T. Characterizing the pharmacogenome using molecular inversion probes for targeted next-generation sequencing. Pharmacogenomics 2019; 20:1005-1020. [DOI: 10.2217/pgs-2019-0057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Aim: This study assesses the technical performance and cost of a targeted next-generation sequencing (NGS) multigene pharmacogenetic (PGx) test. Materials & methods: A genetic test was developed for 21 PGx genes using molecular inversion probes to generate library fragments for NGS. Performance of this test was assessed using 53 unique reference control cell lines from the Genetic Testing Reference Materials Coordination Program (GeT-RM). Results: 93.7% of variants were successfully called and the repeatability rate was 99.9%. Reference calls were available for 78.4% of diplotype calls resulting from PGx testing, and concordance for the test was 85.7%. Cost per sample was $32–$56. Conclusion: A targeted NGS assay using molecular inversion probe technology is able to characterize the pharmacogenome efficiently.
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Affiliation(s)
- Oscar Suzuki
- Division of Pharmacotherapy & Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Center for Pharmacogenomics & Individualized Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Olivia M Dong
- Division of Pharmacotherapy & Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Center for Pharmacogenomics & Individualized Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Rachel M Howard
- Division of Pharmacotherapy & Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Center for Pharmacogenomics & Individualized Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Tim Wiltshire
- Division of Pharmacotherapy & Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Center for Pharmacogenomics & Individualized Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Hicks JK, Aquilante CL, Dunnenberger HM, Gammal RS, Funk RS, Aitken SL, Bright DR, Coons JC, Dotson KM, Elder CT, Groff LT, Lee JC. Precision Pharmacotherapy: Integrating Pharmacogenomics into Clinical Pharmacy Practice. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2019; 2:303-313. [PMID: 32984775 DOI: 10.1002/jac5.1118] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Precision pharmacotherapy encompasses the use of therapeutic drug monitoring; evaluation of liver and renal function, genomics, and environmental and lifestyle exposures; and analysis of other unique patient or disease characteristics to guide drug selection and dosing. This paper articulates real-world clinical applications of precision pharmacotherapy, focusing exclusively on the emerging field of clinical pharmacogenomics. This field is evolving rapidly, and clinical pharmacists now play an invaluable role in the clinical implementation, education, and research applications of pharmacogenomics. This paper provides an overview of the evolution of pharmacogenomics in clinical pharmacy practice, together with recommendations on how the American College of Clinical Pharmacy (ACCP) can support the advancement of clinical pharmacogenomics implementation, education, and research. Commonalities among successful clinical pharmacogenomics implementation and education programs are identified, with recommendations for how ACCP can leverage and advance these common themes. Opportunities are also provided to support the research needed to move the practice and application of pharmacogenomics forward.
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Haga SB, Moaddeb J. Pharmacogenomics courses in pharmacy school curricula. Pharmacogenomics 2019; 20:625-630. [PMID: 31250728 PMCID: PMC6912845 DOI: 10.2217/pgs-2019-0024] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 04/30/2019] [Indexed: 12/17/2022] Open
Abstract
Aim: The appropriate use and integration of pharmacogenetic (PGx) testing will pivot on provider preparation and training. Pharmacists have been recognized as one of the key providers in the delivery of PGx testing and as such, professional organizations have recommended inclusion of PGx content in pharmacy curricula. Methods: We reviewed the curriculum of 132 US pharmacy schools for information about PGx courses. Results: A total of 70 core curriculum courses were identified. 55 (42%) pharmacy schools included at least one PGx course as part of the core curriculum, and ten (8%) schools that offered a PGx course elective. Conclusion: While many pharmacy schools have responded to the accreditation standards to include PGx, less than half of the schools have developed a standalone course.
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Affiliation(s)
- Susanne B Haga
- Department of Medicine, Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, 304 Research Drive, Durham, NC 27708, USA
| | - Jivan Moaddeb
- Department of Medicine, Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, 304 Research Drive, Durham, NC 27708, USA
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Primary Care Physicians' Knowledge, Attitudes, and Experience with Personal Genetic Testing. J Pers Med 2019; 9:jpm9020029. [PMID: 31137623 PMCID: PMC6617198 DOI: 10.3390/jpm9020029] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 02/07/2023] Open
Abstract
Primary care providers (PCPs) will play an important role in precision medicine. However, their lack of training and knowledge about genetics and genomics may limit their ability to advise patients or interpret or utilize test results. We evaluated PCPs’ awareness of the role of genetics/genomics in health, knowledge about key concepts in genomic medicine, perception/attitudes towards direct-to-consumer (DTC) genetic testing, and their level of confidence/comfort in discussing testing with patients prior to and after undergoing DTC testing through the 23andMe Health + Ancestry Service. A total of 130 PCPs completed the study. Sixty-three percent were board-certified in family practice, 32% graduated between 1991 and 2000, and 88% had heard of 23andMe prior to the study. Seventy-two percent decided to participate in the study to gain a better understanding about testing. At baseline, 23% of respondents indicated comfort discussing genetics as a risk factor for common diseases, increasing to 59% after undergoing personal genetic testing (PGT) (p < 0.01). In summary, we find that undergoing PGT augments physicians’ confidence, comfort, and interest in DTC testing.
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Coriolan S, Arikawe N, Moscati A, Zhou L, Dym S, Donmez S, Garba A, Falbaum S, Loewy Z, Lull M, Saad M, Shtaynberg J, Obeng AO. Pharmacy students' attitudes and perceptions toward pharmacogenomics education. Am J Health Syst Pharm 2019; 76:836-845. [PMID: 31415690 PMCID: PMC6523044 DOI: 10.1093/ajhp/zxz060] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To evaluate final-year pharmacy students' perceptions toward pharmacogenomics education, their attitudes on its clinical relevance, and their readiness to use such knowledge in practice. METHODS A 19-question survey was developed and modified from prior studies and was pretested on a small group of pharmacogenomics faculty and pharmacy students. The final survey was administered to 978 final-year pharmacy students in 8 school/colleges of pharmacy in New York and New Jersey between January and May 2017. The survey targeted 3 main themes: perceptions toward pharmacogenomics education, attitudes toward the clinical relevance of this education, and the students' readiness to use knowledge of pharmacogenomics in practice. RESULTS With a 35% response rate, the majority (81%) of the 339 student participants believed that pharmacogenomics was a useful clinical tool for pharmacists, yet only 40% felt that it had been a relevant part of their training. Almost half (46%) received only 1-3 lectures on pharmacogenomics and the majority were not ready to use it in practice. Survey results pointed toward practice-based trainings such as pharmacogenomics rotations as the most helpful in preparing students for practice. CONCLUSIONS Final-year student pharmacists reported varying exposure to pharmacogenomics content in their pharmacy training and had positive attitudes toward the clinical relevance of the discipline, yet they expressed low confidence in their readiness to use this information in practice.
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Affiliation(s)
- Shanice Coriolan
- Candidate 2019, Albany College of Pharmacy and Health Sciences, Albany, NY
| | - Nimota Arikawe
- Candidate 2020, Albany College of Pharmacy and Health Sciences, Albany, NY
| | - Arden Moscati
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lisheng Zhou
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Stephanie Dym
- Touro College of Pharmacy, Touro College, New York, NY
| | - Seda Donmez
- Wegmans School of Pharmacy, St. John Fisher College, Rochester, NY
| | - Adinoyi Garba
- D’Youville College School of Pharmacy, D’Youville College, Buffalo, NY
| | - Sasha Falbaum
- Fairleigh Dickinson College School of Pharmacy, Fairleigh Dickinson University, Teaneck, NJ
| | - Zvi Loewy
- Touro College of Pharmacy, Touro College, New York, NY
| | - Melinda Lull
- Wegmans School of Pharmacy, St. John Fisher College, Rochester, NY
| | - Maha Saad
- College of Pharmacy and Health Sciences, St. Johns University, Jamaica, NY
| | - Jane Shtaynberg
- Department of Experiential Education, LIU Brooklyn Arnold & Marie Schwartz College of Pharmacy, Brooklyn, NY
| | - Aniwaa Owusu Obeng
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
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Shatnawi A, Khanfar NM, Latif DA, Shear M. A comparative study of the depth, breadth, and perception of pharmacogenomics instruction in a subgroup of US pharmacy curricula. CURRENTS IN PHARMACY TEACHING & LEARNING 2019; 11:476-484. [PMID: 31171249 DOI: 10.1016/j.cptl.2019.02.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 12/19/2018] [Accepted: 02/07/2019] [Indexed: 05/22/2023]
Abstract
INTRODUCTION This study was designed to assess the depth, breadth, and perception of pharmacogenomics education in pharmacy curricula in the United States (US). METHODS A modified, online questionnaire from previous studies was sent to all accredited US schools and colleges of pharmacy. The survey covered three distinct areas related to the schools' educational environments, the depth and the extent of pharmacogenomics core competencies and topics taught, and the institutions' perceptions of the importance of pharmacogenomics in the curriculum and future plans for expanded pharmacogenomics education. Multiple approaches were used to increase the response rate, and results were analyzed using descriptive statistics. RESULTS Of the 133 eligible programs, 32 participated in the survey. Six invalid surveys were excluded from our study, resulting in a 19.6% response rate. Results revealed that all responding schools included pharmacogenomics in the curriculum. Interestingly, 76.9% of the respondents believed pharmacists do not have the appropriate knowledge of pharmacogenomics. However, only 30.7% indicated that their programs planned to expand pharmacogenomics in their curriculum. CONCLUSIONS The responding schools all included some pharmacogenomics in their curriculum. However, the depth and the extent of pharmacogenomics topics covered varied. Respondents perceived that pharmacists today do not possess the appropriate level of pharmacogenomics knowledge. Despite this, there is limited emphasis on expanding pharmacogenomics instruction in the responding schools' curriculums.
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Affiliation(s)
- Aymen Shatnawi
- Department of Pharmaceutical and Administrative Sciences, University of Charleston School of Pharmacy, 2300 MacCorkle Ave SE, Charleston, WV 25304, United States.
| | - Nile M Khanfar
- Department of Sociobehavioral and Administrative Pharmacy, College of Pharmacy - Palm Beach, Nova Southeastern University, 11501 N. Military Trail, Palm Beach Gardens, FL 33410, United States.
| | - David A Latif
- Department of Pharmaceutical and Administrative Sciences, University of Charleston School of Pharmacy, 2300 MacCorkle Ave SE, Charleston, WV 25304, United States.
| | - Monica Shear
- The Medical Center of Aurora, 1501 S. Potomac St., Aurora, CO 80012, United States.
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Berenbrok LA, Hart KM, McGrath SH, Coley KC, Somma McGivney MA, Empey PE. Community pharmacists' educational needs for implementing clinical pharmacogenomic services. J Am Pharm Assoc (2003) 2019; 59:539-544. [PMID: 31010787 DOI: 10.1016/j.japh.2019.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/09/2019] [Accepted: 03/08/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Pharmacist leadership and knowledge of pharmacogenomics is critical to the acceleration and enhancement of clinical pharmacogenomic services. This study aims for a qualitative description of community pharmacists' pharmacogenomic educational needs when implementing clinical pharmacogenomic services at community pharmacies. METHODS Pharmacists practicing at Rite Aid Pharmacy locations in the Greater Pittsburgh Area were recruited to participate in this qualitative analysis. Pharmacists from pharmacy locations offering pharmacogenomic testing and robust patient care services were eligible to participate in a semistructured, audio-recorded interview. The semistructured interview covered 4 domains crafted by the investigative team: (1) previous knowledge of pharmacogenomics; (2) implementation resources; (3) workflow adaptation; and (4) learning preferences. Interviews were transcribed verbatim and independently coded by 2 researchers. A thematic analysis by the investigative team followed. Supporting quotes were selected to illustrate each theme. RESULTS Eleven pharmacists from 9 unique pharmacy locations participated in this study. The average length of practice as a community pharmacist was 12 years (range, 1.5-31 years). Pharmacist's pharmacogenomic educational needs were categorized into 5 key themes: (1) enriched pharmacogenomic education and training; (2) active learning to build confidence in using pharmacogenomic data in practice; (3) robust and reputable clinical resources to effectively implement pharmacogenomic services; (4) team-based approach throughout implementation; (5) readily accessible network of pharmacogenomic experts. CONCLUSION This study describes the educational needs and preferences of community pharmacists for the successful provision of clinical pharmacogenomic services in community pharmacies. Pharmacists recognized their needs for enriched knowledge and instruction, practice applying pharmacogenomic principles with team-based approaches, robust clinical resources, and access to pharmacogenomic experts. This deeper understanding of pharmacist needs for pharmacogenomic education could help to accelerate and enhance the clinical implementation of pharmacogenomic services led by community pharmacists.
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45
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Chang A, Nelson R, Brixner D. Advancing pharmacy practice by reducing gaps in pharmacogenetic education. Am J Health Syst Pharm 2019; 76:320-326. [PMID: 30753288 DOI: 10.1093/ajhp/zxy066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Annie Chang
- University of California, San Francisco School of Pharmacy, San Francisco, CA
| | - Ryan Nelson
- Department of Individualized Cancer Management, Moffitt Cancer Center, ?Tampa, FL
| | - Diana Brixner
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT.,Program in Personalized Healthcare, University of Utah, Salt Lake City, UT
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46
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Characteristics and evaluation outcomes of genomics curricula for health professional students: a systematic literature review. Genet Med 2018; 21:1675-1682. [DOI: 10.1038/s41436-018-0386-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 11/16/2018] [Indexed: 11/09/2022] Open
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47
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Mahmutovic L, Akcesme B, Durakovic C, Akcesme FB, Maric A, Adilovic M, Hamad N, Wjst M, Feeney O, Semiz S. Perceptions of students in health and molecular life sciences regarding pharmacogenomics and personalized medicine. Hum Genomics 2018; 12:50. [PMID: 30424805 PMCID: PMC6234656 DOI: 10.1186/s40246-018-0182-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/28/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Increasing evidence is demonstrating that a patient's unique genetic profile can be used to detect the disease's onset, prevent its progression, and optimize its treatment. This led to the increased global efforts to implement personalized medicine (PM) and pharmacogenomics (PG) in clinical practice. Here we investigated the perceptions of students from different universities in Bosnia and Herzegovina (BH) towards PG/PM as well as related ethical, legal, and social implications (ELSI). This descriptive, cross-sectional study is based on the survey of 559 students from the Faculties of Medicine, Pharmacy, Health Studies, Genetics, and Bioengineering and other study programs. RESULTS Our results showed that 50% of students heard about personal genome testing companies and 69% consider having a genetic test done. A majority of students (57%) agreed that PM represents a promising healthcare model, and 40% of students agreed that their study program is well designed for understanding PG/PM. This latter opinion seems to be particularly influenced by the field of study (7.23, CI 1.99-26.2, p = 0.003). Students with this opinion are also more willing to continue their postgraduate education in the PM (OR = 4.68, CI 2.59-8.47, p < 0.001). Furthermore, 45% of students are aware of different ethical aspects of genetic testing, with most of them (46%) being concerned about the patient's privacy. CONCLUSIONS Our results indicate a positive attitude of biomedical students in Bosnia and Herzegovina towards genetic testing and personalized medicine. Importantly, our results emphasize the key importance of pharmacogenomic education for more efficient translation of precision medicine into clinical practice.
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Affiliation(s)
- Lejla Mahmutovic
- Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka cesta 15, 71210 Ilidza, Sarajevo, Bosnia and Herzegovina
| | - Betul Akcesme
- Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka cesta 15, 71210 Ilidza, Sarajevo, Bosnia and Herzegovina.,Department of Medical Biology, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Camil Durakovic
- Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka cesta 15, 71210 Ilidza, Sarajevo, Bosnia and Herzegovina
| | - Faruk Berat Akcesme
- Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka cesta 15, 71210 Ilidza, Sarajevo, Bosnia and Herzegovina.,Department of Biostatistics and Medical Informatics, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Aida Maric
- Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka cesta 15, 71210 Ilidza, Sarajevo, Bosnia and Herzegovina
| | - Muhamed Adilovic
- Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka cesta 15, 71210 Ilidza, Sarajevo, Bosnia and Herzegovina
| | - Nour Hamad
- Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka cesta 15, 71210 Ilidza, Sarajevo, Bosnia and Herzegovina
| | - Matthias Wjst
- Helmholtz Zentrum Muenchen, German Research Center for Environmental Health (GmbH), Ingolstaedter Landstraße 1, D-85764, Munich, Neuherberg, Germany
| | - Oliver Feeney
- Centre of Bioethical Research and Analysis, National University of Ireland (Galway), Galway, Republic of Ireland
| | - Sabina Semiz
- Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka cesta 15, 71210 Ilidza, Sarajevo, Bosnia and Herzegovina.
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Marcinak R, Paris M, Kinney SRM. Pharmacogenomics Education Improves Pharmacy Student Perceptions of Their Abilities and Roles in Its Use. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2018; 82:6424. [PMID: 30559496 PMCID: PMC6291667 DOI: 10.5688/ajpe6424] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 06/15/2017] [Indexed: 05/27/2023]
Abstract
Objective. To assess whether a required first-year course, Principles in Genetics and Pharmacogenomics, and integration into subsequent courses affected pharmacy students' perceptions of pharmacogenomics. Methods. A survey was distributed to Professional Year (PY) 1 students during the first and last weeks of the course from 2014 to 2016. A follow-up survey was distributed to PY2, PY3, and PY4 students. Results. Respondents consistently agreed that pharmacogenomics is clinically relevant. After the course, PY1 students are more comfortable in their knowledge and role in the application of pharmacogenomics. Although their comfort reverts to some degree, PY2-PY4 students believe that they should be able to apply pharmacogenomics clinically. Most PY2-PY4 students indicate that later courses review pharmacogenomics. Conclusion. A required course in genetics and pharmacogenomics can promote a perception that pharmacists should have knowledge of, and be involved in the use of genetic information clinically. Inclusion of pharmacogenomic concepts in subsequent curricular components may help in maintaining these perceptions.
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Affiliation(s)
- Rebecca Marcinak
- Western New England University, College of Pharmacy, Springfield, Massachusetts
| | - Meaghan Paris
- Western New England University, College of Pharmacy, Springfield, Massachusetts
| | - Shannon R M Kinney
- Western New England University, College of Pharmacy, Springfield, Massachusetts
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Frick A, Benton C, Suzuki O, Dong O, Howard R, El-Sabae H, Wiltshire T. Implementing Clinical Pharmacogenomics in the Classroom: Student Pharmacist Impressions of an Educational Intervention Including Personal Genotyping. PHARMACY 2018; 6:pharmacy6040115. [PMID: 30360487 PMCID: PMC6306770 DOI: 10.3390/pharmacy6040115] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/28/2018] [Accepted: 10/01/2018] [Indexed: 01/07/2023] Open
Abstract
Pharmacogenomics provides a personalized approach to pharmacotherapy by using genetic information to guide drug dosing and selection. However, partly due to lack of education, pharmacogenomic testing has not been fully implemented in clinical practice. With pharmacotherapy training and patient accessibility, pharmacists are ideally suited to apply pharmacogenomics to patient care. Student pharmacists (n = 222) participated in an educational intervention that included voluntary personal genotyping using 23andMe. Of these, 31% of students completed both pre- and post-educational interventions to evaluate their attitudes and confidence towards the use of pharmacogenomics data in clinical decision making, and 55% of this paired subset obtained personal genotyping. McNemar’s test and the Wilcoxon signed-rank test were used to analyze responses. Following the educational intervention, students regardless of genotyping were more likely to recommend personal genotyping (36% post-educational intervention versus 19% pre-educational intervention, p = 0.0032), more confident in using pharmacogenomics in the management of drug therapy (51% post-educational intervention versus 29% pre-educational intervention, p = 0.0045), and more likely to believe that personalized genomics would have an important role in their future pharmacy career (90% post-educational intervention versus 51% pre-educational intervention, p = 0.0072) compared to before receiving the educational intervention. This educational intervention positively influenced students’ attitudes and confidence regarding pharmacogenomics in the clinical setting. Future studies will examine the use of next-generation sequencing assays that selectively examine pharmacogenes in the education of student pharmacists.
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Affiliation(s)
- Amber Frick
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
| | - Cristina Benton
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
| | - Oscar Suzuki
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
| | - Olivia Dong
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
| | - Rachel Howard
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
| | - Hijrah El-Sabae
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
| | - Tim Wiltshire
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
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50
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Abstract
Pharmacogenomics is a tool for practitioners to provide precision pharmacotherapy using genomics. All providers are likely to encounter genomic data in practice with the expectation that they are able to successfully apply it to patient care. Pharmacogenomics tests for genetic variations in genes that are responsible for drug metabolism, transport, and targets of drug action. Variations can increase the risk for drug toxicity or poor efficacy. Pharmacogenomics can, therefore, be used to help select the best medication or aid in dosing. Nephrologists routinely treat cardiovascular disease and manage patients after kidney transplantation, two situations for which there are several high-evidence clinical recommendations for commonly used anticoagulants, antiplatelets, statins, and transplant medications. Successful use of pharmacogenomics in practice requires that providers are familiar with how to access and use pharmacogenomics resources. Similarly, clinical decision making related to whether to use existing data, whether to order testing, and if data should be used in practice is needed to deliver precision medicine. Pharmacogenomics is applicable to virtually every medical specialty, and nephrologists are well positioned to be implementation leaders.
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Affiliation(s)
| | | | - Philip E. Empey
- Department of Pharmacy and Therapeutics, School of Pharmacy, and
- Institute and of Precision Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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