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克服障碍:在瑞士临床实践中实施药师主导的药物基因组学服务的策略。

Overcoming Barriers: Strategies for Implementing Pharmacist-Led Pharmacogenetic Services in Swiss Clinical Practice.

机构信息

Pharmaceutical Care, Department of Pharmaceutical Sciences, University of Basel, 4056 Basel, Switzerland.

Institute of Hospital Pharmacy, Solothurner Spitäler, 4600 Olten, Switzerland.

出版信息

Genes (Basel). 2024 Jul 1;15(7):862. doi: 10.3390/genes15070862.


DOI:10.3390/genes15070862
PMID:39062642
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11276441/
Abstract

There is growing evidence that pharmacogenetic analysis can improve drug therapy for individual patients. In Switzerland, pharmacists are legally authorized to initiate pharmacogenetic tests. However, pharmacogenetic tests are rarely conducted in Swiss pharmacies. Therefore, we aimed to identify implementation strategies that facilitate the integration of a pharmacist-led pharmacogenetic service into clinical practice. To achieve this, we conducted semi-structured interviews with pharmacists and physicians regarding the implementation process of a pharmacist-led pharmacogenetic service. We utilized the Consolidated Framework for Implementation Research (CFIR) to identify potential facilitators and barriers in the implementation process. Additionally, we employed Expert Recommendations for Implementing Change (ERIC) to identify strategies mentioned in the interviews and used the CFIR-ERIC matching tool to identify additional strategies. We obtained interview responses from nine pharmacists and nine physicians. From these responses, we identified 7 CFIR constructs as facilitators and 12 as barriers. Some of the most commonly mentioned barriers included unclear procedures, lack of cost coverage by health care insurance, insufficient pharmacogenetics knowledge, lack of interprofessional collaboration, communication with the patient, and inadequate e-health technologies. Additionally, we identified 23 implementation strategies mentioned by interviewees using ERIC and 45 potential strategies using the CFIR-ERIC matching tool. In summary, we found that significant barriers hinder the implementation process of this new service. We hope that by highlighting potential implementation strategies, we can advance the integration of a pharmacist-led pharmacogenetic service in Switzerland.

摘要

越来越多的证据表明,药物遗传学分析可以改善个体患者的药物治疗效果。在瑞士,药剂师在法律上被授权启动药物遗传学测试。然而,瑞士的药店很少进行药物遗传学测试。因此,我们旨在确定实施策略,以促进由药剂师主导的药物遗传学服务融入临床实践。为了实现这一目标,我们对药剂师和医生进行了半结构化访谈,了解由药剂师主导的药物遗传学服务的实施过程。我们利用实施研究综合框架(CFIR)来确定实施过程中的潜在促进因素和障碍。此外,我们还采用了实施变革的专家建议(ERIC)来识别访谈中提到的策略,并使用 CFIR-ERIC 匹配工具来识别其他策略。我们从九名药剂师和九名医生那里获得了访谈回复。从这些回复中,我们确定了 7 个 CFIR 结构作为促进因素,12 个作为障碍。一些最常提到的障碍包括程序不明确、医疗保险未涵盖成本、药物遗传学知识不足、缺乏跨专业合作、与患者沟通以及电子健康技术不足。此外,我们还使用 ERIC 识别了 23 项受访者提到的实施策略,并使用 CFIR-ERIC 匹配工具识别了 45 项潜在策略。总之,我们发现,有一些重大障碍阻碍了这项新服务的实施过程。我们希望通过强调潜在的实施策略,能够推动瑞士由药剂师主导的药物遗传学服务的整合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e06a/11276441/1d8d97d95ce0/genes-15-00862-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e06a/11276441/1d8d97d95ce0/genes-15-00862-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e06a/11276441/1d8d97d95ce0/genes-15-00862-g001.jpg

相似文献

[1]
Overcoming Barriers: Strategies for Implementing Pharmacist-Led Pharmacogenetic Services in Swiss Clinical Practice.

Genes (Basel). 2024-7-1

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[7]
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[8]
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引用本文的文献

[1]
Barriers and facilitators for implementing a pharmacogenetic passport: lessons learned from reusing sequencing data.

Pharmacogenomics. 2025

[2]
Impact and Enablers of Pharmacogenetic-Informed Treatment Decisions-A Longitudinal Mixed-Methods Study Exploring the Patient Perspective.

Pharmacy (Basel). 2025-1-31

[3]
Studying Rare Movement Disorders: From Whole-Exome Sequencing to New Diagnostic and Therapeutic Approaches in a Modern Genetic Clinic.

Biomedicines. 2024-11-23

本文引用的文献

[1]
Antiplatelet therapy guided by point-of-care pharmacogenetics plus multidimensional treatment decisions.

Pharmacogenomics. 2024-1

[2]
Cost-effectiveness of pharmacogenomic-guided treatment for major depression.

CMAJ. 2023-11-14

[3]
Cost-utility analysis and cross-country comparison of pharmacogenomics-guided treatment in colorectal cancer patients participating in the U-PGx PREPARE study.

Pharmacol Res. 2023-11

[4]
Genotyping of Patients with Adverse Drug Reaction or Therapy Failure: Database Analysis of a Pharmacogenetics Case Series Study.

Pharmgenomics Pers Med. 2023-7-3

[5]
Pharmacogenetic testing and counselling in the community pharmacy: mixed-methods study of a new pharmacist-led service.

Int J Clin Pharm. 2023-12

[6]
Economic evaluation of pharmacogenomic-guided antiplatelet treatment in Spanish patients suffering from acute coronary syndrome participating in the U-PGx PREPARE study.

Hum Genomics. 2023-6-7

[7]
Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A Genotypes and Serotonin Reuptake Inhibitor Antidepressants.

Clin Pharmacol Ther. 2023-7

[8]
A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study.

Lancet. 2023-2-4

[9]
Utilization of Drugs with Pharmacogenetic Dosing Recommendations in Switzerland: A Descriptive Study Using the Helsana Database.

Pharmgenomics Pers Med. 2022-11-23

[10]
The updated Consolidated Framework for Implementation Research based on user feedback.

Implement Sci. 2022-10-29

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