Luzum J A, Pakyz R E, Elsey A R, Haidar C E, Peterson J F, Whirl-Carrillo M, Handelman S K, Palmer K, Pulley J M, Beller M, Schildcrout J S, Field J R, Weitzel K W, Cooper-DeHoff R M, Cavallari L H, O'Donnell P H, Altman R B, Pereira N, Ratain M J, Roden D M, Embi P J, Sadee W, Klein T E, Johnson J A, Relling M V, Wang L, Weinshilboum R M, Shuldiner A R, Freimuth R R
Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA.
Center for Pharmacogenomics, College of Medicine, Ohio State University, Columbus, Ohio, USA.
Clin Pharmacol Ther. 2017 Sep;102(3):502-510. doi: 10.1002/cpt.630. Epub 2017 Jun 9.
Numerous pharmacogenetic clinical guidelines and recommendations have been published, but barriers have hindered the clinical implementation of pharmacogenetics. The Translational Pharmacogenetics Program (TPP) of the National Institutes of Health (NIH) Pharmacogenomics Research Network was established in 2011 to catalog and contribute to the development of pharmacogenetic implementations at eight US healthcare systems, with the goal to disseminate real-world solutions for the barriers to clinical pharmacogenetic implementation. The TPP collected and normalized pharmacogenetic implementation metrics through June 2015, including gene-drug pairs implemented, interpretations of alleles and diplotypes, numbers of tests performed and actionable results, and workflow diagrams. TPP participant institutions developed diverse solutions to overcome many barriers, but the use of Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines provided some consistency among the institutions. The TPP also collected some pharmacogenetic implementation outcomes (scientific, educational, financial, and informatics), which may inform healthcare systems seeking to implement their own pharmacogenetic testing programs.
众多药物遗传学临床指南和建议已发布,但一些障碍阻碍了药物遗传学在临床中的应用。美国国立卫生研究院(NIH)药物基因组学研究网络的转化药物遗传学项目(TPP)于2011年成立,旨在梳理并推动美国八个医疗系统的药物遗传学应用发展,目标是传播针对临床药物遗传学应用障碍的实际解决方案。TPP收集并规范了截至2015年6月的药物遗传学应用指标,包括实施的基因-药物对、等位基因和双倍型的解读、检测数量和可采取行动的结果,以及工作流程图。TPP参与机构开发了多种解决方案来克服诸多障碍,但使用临床药物遗传学实施联盟(CPIC)指南为各机构提供了一定的一致性。TPP还收集了一些药物遗传学应用成果(科学、教育、财务和信息学方面),这可能会为寻求实施自身药物遗传学检测项目的医疗系统提供参考。