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荷兰通过社区药房实施药物基因组检测服务:早期服务评估结果

Implementation of a Pharmacogenomic Testing Service through Community Pharmacy in the Netherlands: Results from an Early Service Evaluation.

作者信息

Thornley Tracey, Esquivel Bernard, Wright David J, Dop Hidde van den, Kirkdale Charlotte L, Youssef Essra

机构信息

Boots UK, Thane Road, Nottingham NG90 1BS, UK.

School of Pharmacy, University of Nottingham, University Park, Nottingham NG7 2RD, UK.

出版信息

Pharmacy (Basel). 2021 Feb 12;9(1):38. doi: 10.3390/pharmacy9010038.

Abstract

Community pharmacy services have evolved to include medical and pharmaceutical interventions alongside dispensing. While established pharmacogenomic (PGx) testing is available throughout the Netherlands, this is primarily based in hospital environments and for specialist medicines. The aim of this work was to describe how best to implement PGx services within community pharmacy, considering potential barriers and enablers to service delivery and how to address them. The service was implemented across a selection of community pharmacies in the Netherlands. Data were captured on test outcomes and through a pharmacist survey. Following testing, 17.8% of the clinical samples were recommended to avoid certain medication (based on their current medicines use), and 14.0% to have their dose adjusted. Pre-emptive analysis of genotyped patients showed that the majority (99.2%) had actionable variants. Pharmacists felt confident in their operational knowledge to deliver the service, but less so in applying that knowledge. Delivering the service was believed to improve relationships with other healthcare professionals. These results add to the evidence in understanding how PGx can be delivered effectively within the community pharmacy environment. Training pharmacists in how to respond to patient queries and make clinical recommendations may enhance service provision further.

摘要

社区药房服务已发展到在配药的同时还包括医疗和药学干预。虽然荷兰各地都有成熟的药物基因组学(PGx)检测,但主要是在医院环境中针对专科药物进行检测。这项工作的目的是描述如何在社区药房中最好地实施PGx服务,考虑到服务提供的潜在障碍和促进因素以及如何应对这些因素。该服务在荷兰的一些社区药房中实施。收集了检测结果的数据,并通过药剂师调查进行了数据收集。检测后,17.8%的临床样本被建议避免使用某些药物(基于其当前的用药情况),14.0%的样本被建议调整剂量。对基因分型患者的前瞻性分析表明,大多数(99.2%)有可采取行动的变异。药剂师对提供该服务的操作知识有信心,但在应用这些知识方面信心不足。提供该服务被认为可以改善与其他医疗保健专业人员的关系。这些结果为理解如何在社区药房环境中有效提供PGx服务增添了证据。对药剂师进行如何回应患者咨询和提出临床建议的培训可能会进一步提高服务质量。

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