Moaddeb Jivan, Mills Rachel, Haga Susanne B
Clinical Pharmacist, Center for Applied Genomics and Precision Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC.
Clinical Research Coordinator and Genetic Counselor, Center for Applied Genomics and Precision Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC.
J Am Pharm Assoc (2003). 2015 Nov-Dec;55(6):587-594. doi: 10.1331/JAPhA.2015.15017.
Appendix 1 Statements of knowledge of correct medication use Appendix 2 Statements of self-efficacy of correct medication use Appendix 3 Statements of skills of correct medication use To characterize the experiences and feasibility of offering pharmacogenetic (PGx) testing in a community pharmacy setting.
Pharmacists were invited to complete a survey about PGx testing for each patient who was offered testing. If the patient consented, pharmacists were also asked to complete a follow-up survey about the process of returning PGx testing results to patients and follow-up with the prescribing provider.
Community pharmacies in North Carolina from August through November 2014.
Pharmacists at five community pharmacies.
Patient consent for testing, time to introduce PGx testing initially and communicate results, interpretation of test results, and recommended medication changes.
Of the 69 patients offered testing, 56 (81%) consented. Pre-test counseling typically lasted 1-5 minutes (81%), and most patients (55%) did not have any questions about the testing. Most pharmacists reported test results to patients by phone (84%), with discussions taking less than 1 minute (48%) or 1-5 minutes (52%). Most pharmacists believed the patients understood their results either very well (54%) or somewhat well (41%). Pharmacists correctly interpreted 47 of the 53 test results (89%). All of the incorrect interpretations were for patients with test results indicating a dosing or drug change (6/19; 32%). Pharmacists reported contacting the ordering physician for four patients to discuss results indicating a dosage or drug change.
The provision of PGx services in a community pharmacy setting appears feasible, requiring little additional time from the pharmacist, and many patients seem interested in PGx testing. Additional training may be necessary to improve test result interpretation, as well as for communication with both patients and ordering physicians.
附录1正确用药知识声明 附录2正确用药自我效能声明 附录3正确用药技能声明 描述在社区药房环境中提供药物基因检测(PGx)的经验和可行性。
邀请药剂师针对每一位接受检测的患者完成一项关于PGx检测的调查。如果患者同意,还会要求药剂师完成一项关于向患者反馈PGx检测结果的过程以及与开处方医生进行后续沟通的随访调查。
2014年8月至11月期间北卡罗来纳州的社区药房。
五家社区药房的药剂师。
患者对检测的同意情况、首次介绍PGx检测及传达结果的时间、检测结果的解读以及推荐的用药更改。
在69位接受检测邀请的患者中,56位(81%)同意。检测前咨询通常持续1 - 5分钟(81%),大多数患者(55%)对检测没有任何疑问。大多数药剂师通过电话向患者报告检测结果(84%),讨论时间少于1分钟(48%)或1 - 5分钟(52%)。大多数药剂师认为患者对检测结果理解得很好(54%)或还算可以(41%)。药剂师正确解读了53项检测结果中的47项(89%)。所有错误解读均针对检测结果显示需要调整剂量或更换药物的患者(6/19;32%)。药剂师报告称,针对4位患者联系了开单医生以讨论检测结果显示需要调整剂量或更换药物的情况。
在社区药房环境中提供PGx服务似乎是可行的,药剂师只需花费很少额外时间即可,而且许多患者似乎对PGx检测感兴趣。可能需要额外培训以改善检测结果的解读,以及与患者和开单医生的沟通。