University of Bath, Claverton Down, Bath, BA2 7AY, UK.
University of Leicester, University Rd, Leicester, LE1 7RH, UK.
Int J Clin Pharm. 2022 Dec;44(6):1406-1416. doi: 10.1007/s11096-022-01483-8. Epub 2022 Oct 10.
Pharmacogenomics is a novel arena of medicine that uses patients' Deoxyribonucleic Acid to support pharmacists and prescribers selecting the most appropriate medicine for patients.
To review and validate a service specification for a pharmacogenomics testing service.
Consensus methods (Delphi method and the Nominal Group Technique) were deployed. A consensus panel comprising of pharmacists, prescribers and patients was convened to participate in the co-design process. Panel members were first surveyed to obtain their views on Behaviour Change Techniques identified as necessary for the service in a previous study. Following this, a workshop was convened to discuss, agree and confirm details for the service specification and recommend strategies for operationalisation. Outputs from the workshop were used to inform a final version of the service specification.
From the consensus panel (pharmacists (n = 6), general practitioners (n = 3) and patients (n = 3)), strategies for operationalisation of nine Behaviour Change Techniques were agreed as being required. In addition, several unique and innovative strategies for implementation of the community pharmacy service were identified and included in the service specification.
The research shows that to encourage community pharmacist engagement in providing a pharmacogenomic testing service and prescriber acceptance of recommendations for any changes to patients' prescriptions, a multi-professional launch event is required. To agree communication strategies and professional boundaries, training in clinical decision making and patient support materials are required as is guidance on how to deliver the service in a standardised manner. Finally, healthcare professionals would be reassured by the provision of an expert help-line for any complex patients.
药物基因组学是医学的一个新兴领域，它利用患者的脱氧核糖核酸（DNA）来支持药剂师和处方医生为患者选择最合适的药物。
审查和验证一项药物基因组学检测服务的服务规范。
采用共识方法（德尔菲法和名义小组技术）。召集了一个由药剂师、处方医生和患者组成的共识小组参与共同设计过程。小组成员首先接受调查，以了解他们对之前研究中确定为服务所需的行为改变技术的看法。在此之后，召开了一次研讨会，讨论、同意并确认服务规范的详细信息，并为实施推荐策略。研讨会的产出被用于提供服务规范的最终版本。
从共识小组（药剂师（n=6）、全科医生（n=3）和患者（n=3））中，一致认为需要实施九个行为改变技术的策略。此外，还确定了一些独特的创新策略，用于实施社区药房服务，并将其纳入服务规范。
研究表明，要鼓励社区药剂师参与提供药物基因组学检测服务，并让处方医生接受对患者处方进行任何更改的建议，需要进行多专业的启动活动。为了达成沟通策略和专业界限，需要进行临床决策制定和患者支持材料的培训，以及如何以标准化方式提供服务的指南。最后，为任何复杂的患者提供专家帮助热线，将使医疗保健专业人员感到安心。
