Frick Amber, Benton Cristina S, Scolaro Kelly L, McLaughlin Jacqueline E, Bradley Courtney L, Suzuki Oscar T, Wang Nan, Wiltshire Tim
Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina Chapel Hill, NC, USA.
Pharmacy Practice Department, School of Pharmacy, Lake Erie College of Osteopathic Medicine Bradenton, FL, USA.
Front Pharmacol. 2016 Aug 8;7:241. doi: 10.3389/fphar.2016.00241. eCollection 2016.
Pharmacogenomics, once hailed as a futuristic approach to pharmacotherapy, has transitioned to clinical implementation. Although logistic and economic limitations to clinical pharmacogenomics are being superseded by external measures such as preemptive genotyping, implementation by clinicians has met resistance, partly due to a lack of education. Pharmacists, with extensive training in pharmacology and pharmacotherapy and accessibility to patients, are ideally suited to champion clinical pharmacogenomics. This study aimed to analyze the outcomes of an innovative pharmacogenomic teaching approach. Second-year student pharmacists enrolled in a required, 15-week pharmaceutical care lab course in 2015 completed educational activities including lectures and small group work focusing on practical pharmacogenomics. Reflecting the current landscape of direct-to-consumer (DTC) genomic testing, students were offered 23andMe genotyping. Students completed surveys regarding their attitudes and confidence on pharmacogenomics prior to and following the educational intervention. Paired pre- and post-intervention responses were analyzed with McNemar's test for binary comparisons and the Wilcoxon signed-rank test for Likert items. Responses between genotyped and non-genotyped students were analyzed with Fisher's exact test for binary comparisons and the Mann-Whitney U-test for Likert items. Responses were analyzed for all student pharmacists who voluntarily completed the pre-intervention survey (N = 121, 83% response) and for student pharmacists who completed both pre- and post-intervention surveys (N = 39, 27% response). Of those who completed both pre- and post-intervention surveys, 59% obtained genotyping. Student pharmacists demonstrated a significant increase in their knowledge of pharmacogenomic resources (17.9 vs. 56.4%, p < 0.0001) and confidence in applying pharmacogenomic information to manage patients' drug therapy (28.2 vs. 48.7%, p = 0.01), particularly if the student had received genotyping. Student pharmacists understanding of the risks and benefits of using personal genome testing services significantly increased (55.3 vs. 86.8%, p = 0.001) along with agreement that personal genomics would likely play an important role in their future career (47.4 vs. 76.3%, p = 0.01), particularly among students who participated in genotyping. The educational intervention, including personal genotyping, was feasible, and positively enhanced students' reflections, and attitudes toward pharmacogenomics in a professional pharmacy program.
药物基因组学曾被誉为药物治疗的未来方法,如今已过渡到临床应用阶段。尽管临床药物基因组学在后勤和经济方面的限制正被诸如抢先基因分型等外部措施所取代,但临床医生在实施过程中遇到了阻力,部分原因是缺乏相关教育。药剂师在药理学和药物治疗方面接受过广泛培训,且易于接触患者,非常适合推动临床药物基因组学的发展。本研究旨在分析一种创新的药物基因组学教学方法的效果。2015年,参加为期15周必修药学服务实验室课程的二年级学生药剂师完成了包括讲座和专注于实用药物基因组学的小组作业在内的教育活动。为反映当前直接面向消费者(DTC)基因检测的情况,为学生提供了23andMe基因分型服务。学生在教育干预前后完成了关于他们对药物基因组学的态度和信心的调查。干预前后的配对反应采用McNemar检验进行二元比较,采用Wilcoxon符号秩检验进行李克特量表项目分析。对进行基因分型和未进行基因分型的学生之间的反应采用Fisher精确检验进行二元比较,采用Mann-Whitney U检验进行李克特量表项目分析。对所有自愿完成干预前调查的学生药剂师(N = 121,回复率83%)以及完成干预前和干预后调查的学生药剂师(N = 39,回复率27%)的反应进行了分析。在完成干预前和干预后调查的学生中,59%进行了基因分型。学生药剂师在药物基因组学资源知识方面有显著增加(17.9%对56.4%,p < 0.0001),并且在应用药物基因组学信息管理患者药物治疗方面的信心也有显著提高(28.2%对48.7%,p = 0.01),特别是如果学生进行了基因分型。学生药剂师对使用个人基因组检测服务的风险和益处的理解显著增加(55.3%对86.8%,p = 0.001),同时也更认同个人基因组学可能在他们未来的职业中发挥重要作用(47.4%对76.3%,p = 0.01),特别是在参与基因分型的学生中。包括个人基因分型在内的教育干预是可行的,并且在专业药学课程中积极增强了学生对药物基因组学的思考和态度。