Department of Genetics, Cell Biology, and Development, University of Minnesota Twin Cities, Minneapolis, Minnesota.
Iowa Institute of Human Genetics, University of Iowa, Iowa City, Iowa.
Pharmacotherapy. 2017 Sep;37(9):990-999. doi: 10.1002/phar.1980. Epub 2017 Aug 7.
Increased use of pharmacogenomic (PGx) testing in the clinical setting has revealed a number of challenges to providing this service. PGx is an important component of precision medicine that brings together the fields of genetics and clinical pharmacology. A model that incorporates a multidisciplinary approach to implementation and information delivery may be the most beneficial to patients and providers. In this review, translational considerations in the provision of PGx testing and counseling services are described. Specifically, we report on the selection of PGx tests, the provision of patient education and counseling, and examples of PGx service delivery models that incorporate counseling by pharmacists and genetic counselors. Examples of ancillary risks associated with PGx testing, testing of children, and familial implications of testing are reviewed. Through multispecialty partnerships, including genetic counselors and pharmacists, implementation obstacles to PGx testing can be overcome to provide quality precision medicine to patients.
在临床环境中越来越多地使用药物基因组学(PGx)检测,这揭示了提供这项服务的一些挑战。PGx 是精准医学的一个重要组成部分,它将遗传学和临床药理学结合在一起。一种采用多学科方法来实施和传递信息的模式,可能对患者和提供者最有益。在这篇综述中,描述了提供 PGx 检测和咨询服务的转化考虑因素。具体而言,我们报告了 PGx 检测的选择、患者教育和咨询的提供,以及纳入药剂师和遗传咨询师咨询的 PGx 服务交付模式的例子。还回顾了与 PGx 检测相关的辅助风险、儿童检测以及检测的家族影响的例子。通过包括遗传咨询师和药剂师在内的多专业合作,可以克服 PGx 检测的实施障碍,为患者提供高质量的精准医学。