Department of Pharmacotherapeutics & Clinical Research, University of South Florida Taneja College of Pharmacy, Tampa, FL.
Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Am J Health Syst Pharm. 2022 Sep 22;79(19):1634-1644. doi: 10.1093/ajhp/zxac189.
This article explores approaches to pharmacogenomic counseling for patients who have undergone multigene panel testing by describing the collective experience of 5 institutions.
Multigene panel pharmacogenomic testing has the potential to unlock a myriad of information about a patient's past, present, and future drug response. The multifaceted nature of drug response coupled with the complexity of genetic results necessitates some form of patient education through pharmacogenomic counseling. Published literature regarding disclosure of pharmacogenomic test results is limited. This article compares the counseling practices of pharmacists from 5 different institutions with pharmacogenomics clinics whose experience represents perspectives ranging from academia to community clinical environments. Overarching counseling themes discussed during result disclosure center around (1) pharmacogenomic results, (2) gene-drug interactions, (3) gene-drug-drug interactions, (4) drug changes (5) future, familial, or disease-risk implications, (6) updates in the interpretation and application of pharmacogenomic results, (7) gauging patient comprehension, and (8) sharing results and supplemental information.
Dedicating time to counseling patients on the results of a multigene pharmacogenomic panel is important given the lifelong applications of a test that is generally performed only once. The content and methods of disclosing test results shared by the experiences of pharmacists at 5 different institutions serve as guide to be further refined as research addresses effective communication strategies that enhance patient comprehension of pharmacogenomic results.
本文通过描述 5 家机构的集体经验，探讨了对接受多基因panel 检测的患者进行药物基因组学咨询的方法。
多基因panel 药物基因组学检测有可能为患者过去、现在和未来的药物反应提供无数信息。药物反应的多面性加上遗传结果的复杂性，需要通过药物基因组学咨询对患者进行某种形式的教育。关于药物基因组学检测结果披露的文献有限。本文比较了来自 5 家不同机构的药师与药物基因组学诊所的咨询实践，这些机构的经验代表了从学术界到社区临床环境的各种观点。在结果披露过程中，总体咨询主题围绕以下几个方面展开：（1）药物基因组学结果；（2）基因-药物相互作用；（3）基因-药物-药物相互作用；（4）药物变化；（5）未来、家族或疾病风险影响；（6）对药物基因组学结果的解释和应用的更新；（7）评估患者的理解程度；（8）分享结果和补充信息。
鉴于该检测通常仅进行一次，但终生适用，因此花时间向患者咨询多基因药物基因组学panel 的检测结果非常重要。5 家不同机构的药师的经验分享的检测结果披露的内容和方法为进一步完善提供了指导，因为研究旨在解决增强患者对药物基因组学结果理解的有效沟通策略。
