- Compare and contrast the patient and healthcare professional access to pharmacogenomic tests.
- Review the roles of health care professionals in patient counseling regarding pharmacogenomic tests.
- Examine the pharmacist-centered patient counseling model and the integration of pharmacogenomic information.
- Explore the application of pharmacogenomic data to patient vignettes.
There is an eminent need for health care professionals to be prepared to integrate pharmacogenomics into clinical care. There is both growing scientific evidence and an interest of the lay press regarding individualized, tailored, or personalized medicine. As a new area of medicine, pharmacogenomics poses many challenges as well as opportunities. For health care professionals, there are challenges in obtaining a baseline understanding of the relevance of pharmacogenomics and maintaining a current understanding of the evidence supporting pharmacogenomics as it relates to patient care. For patients, there are challenges to being willing to provide genetic information for optimizing their medication therapy and to distinguish the less reputable direct-to-consumer options for genetic testing. Opportunities shared by patients and professionals include an understanding that the “one dose fits all” approach is flawed and that pharmacogenomics is one tool to improve our ability to provide the right drug in the right dose to the right patient.
Despite mounting research, the public's understanding of pharmacogenomics is not well documented. Individuals may or may not understand the benefits and risks associated with pharmacogenomics. A study published in 2009 by Kobayashi and Satoh assessed the attitudes of 1,103 Japanese adults from the general public (not a patient population) toward pharmacogenomics research and their willingness to donate samples for a DNA biobank to identify genomic markers associated with adverse drug reactions.1 The majority of the respondents showed a positive attitude toward pharmacogenomics research (81%) and donating to a DNA biobank (70.4%). A decreased willingness to donate was significantly associated with older generations. Generally, the respondents had the following concerns regarding a DNA biobank: the confidentiality of their personal information, the manner by which research results were utilized, and the use of their own DNA for research. The authors concluded that a process of public awareness should be put into place to emphasize the beneficial aspects of identifying genomic markers associated with adverse drug reactions and to address the concerns of confidentiality and research raised in their study.1 Although this study was conducted exclusively in Japan, the same concerns are likely to occur in other countries. Health care professionals, including physicians, nurses, pharmacists, and genetic counselors, are best positioned to play a key role in helping the public better understand and interpret pharmacogenomic information.1
Health care professionals must be exposed to pharmacogenomics during their education so they can comfortably apply this information in clinical practice and educate their patients. They must have at least a cursory knowledge of genetics and an appreciation for the benefits and limitations to pharmacogenetic tests. Currently, the curricula offered among the health care professional schools, such as schools of nursing, medicine, and ...