Ferris State University, College of Pharmacy, USA.
University of Nebraska Medical Center, College of Pharmacy, USA.
Res Social Adm Pharm. 2024 Jun;20(6):152-155. doi: 10.1016/j.sapharm.2024.03.002. Epub 2024 Mar 8.
As pharmacogenomic (PGx) testing becomes more commonplace in clinical practice, appropriate application of laboratory data to all relevant medications becomes necessary to maximize PGx value. However, many clinicians lack PGx knowledge and confidence, so prescribers may appreciate clinical support when applying PGx data to a patient's entire medication list. Pharmacists routinely provide PGx consult support, and asynchronous written consults may improve logistical simplicity, but specific process steps and time expectations are less settled. Four pharmacists produced written consult reports for 18 patient cases across three rounds of review. Discussion took place before each of the three rounds to drive consensus in steps, process, and resources used. Time per process step was tracked in the third round. Asynchronous written PGx consult reports generally required less than 30 min to generate if no more than 2 medications had PGx-based guidance, but that time more than doubled when more medications require PGx-based guidance. After three rounds of review, pharmacists found consensus regarding an optimal workflow for generating a PGx consult. Findings from this study may support pharmacist training, practice management, and expectation management for asynchronous written PGx consult development.
随着药物基因组学（PGx）检测在临床实践中变得越来越普遍，为了最大限度地发挥 PGx 的价值，有必要将实验室数据应用于所有相关药物。然而，许多临床医生缺乏 PGx 知识和信心，因此在将 PGx 数据应用于患者的整个药物清单时，开处方者可能会欣赏临床支持。药剂师通常会提供 PGx 咨询支持，而异步书面咨询可能会提高后勤工作的简单性，但具体的流程步骤和时间预期还不太确定。四位药剂师在三轮审查中为 18 个患者案例生成了书面咨询报告。在三轮审查之前进行了讨论，以推动步骤、流程和使用的资源达成共识。在第三轮审查中，跟踪了每个流程步骤的时间。如果没有超过 2 种药物有基于 PGx 的指导，那么异步书面 PGx 咨询报告通常需要不到 30 分钟即可生成，但当需要基于 PGx 的指导的药物超过 2 种时，生成时间会增加一倍以上。经过三轮审查，药剂师就生成 PGx 咨询的最佳工作流程达成了共识。本研究的结果可能支持药剂师培训、实践管理和异步书面 PGx 咨询开发的期望管理。
