Khelifi Maher, Tarczy-Hornoch Peter, Devine Emily B, Pratt Wanda
University of Washington, Seattle, WA, USA.
AMIA Jt Summits Transl Sci Proc. 2017 Jul 26;2017:237-246. eCollection 2017.
The use of pharmacogenomics (PGx) in clinical practice still faces challenges to fully adopt genetic information in targeting drug therapy. To incorporate genetics into clinical practice, many support the use of Pharmacogenomics Clinical Decision Support Systems (PGx-CDS) for medication prescriptions. This support was fueled by new guidelines to incorporate genetics for optimizing drug dosage and reducing adverse events. In addition, the complexity of PGx led to exploring CDS outside the paradigm of the basic CDS tools embedded in commercial electronic health records. Therefore, designing the right CDS is key to unleashing the full potential of pharmacogenomics and making it a part of clinicians' daily workflow. In this work, we 1) identify challenges and barriers of the implementation of PGx-CDS in clinical settings, 2) develop a new design approach to CDS with functional characteristics that can improve the adoption of pharmacogenomics guidelines and thus patient safety, and 3) create design guidelines and recommendations for such PGx-CDS tools.
在临床实践中使用药物基因组学（PGx）以在靶向药物治疗中充分采用遗传信息仍面临挑战。为了将遗传学纳入临床实践，许多人支持使用药物基因组学临床决策支持系统（PGx-CDS）进行药物处方。将遗传学纳入以优化药物剂量和减少不良事件的新指南推动了这种支持。此外，PGx的复杂性导致在商业电子健康记录中嵌入的基本CDS工具范式之外探索CDS。因此，设计合适的CDS是释放药物基因组学全部潜力并使其成为临床医生日常工作流程一部分的关键。在这项工作中，我们1）识别在临床环境中实施PGx-CDS的挑战和障碍，2）开发一种具有功能特性的新CDS设计方法，该方法可以提高药物基因组学指南的采用率，从而提高患者安全性，3）为此类PGx-CDS工具创建设计指南和建议。
