Leading clinical pharmacogenomics implementation: Advancing pharmacy practice

Clinical pharmacogenomics contributes to optimal pharmacotherapy for a variety of conditions, including heart disease,1 venous thromboembolism,2 cancers,3 and epilepsy,4 by avoiding harmful adverse effects, drug–gene interactions, and ineffective treatment. Selected patients have already benefited from pharmacogenomic testing, as genetic markers are increasingly used to guide warfarin dosing,5 improve responses to antiplatelet therapy,6 and reduce toxicity from thiopurine therapy.7,8 There is growing consensus that pharmacogenomics is an essential component of pharmacy practice and, correspondingly, that pharmacists should lead implementation efforts in this area. Consensus recommendations developed as part of ASHP’s Pharmacy Practice Model Initiative (PPMI) underscore this point, as 74% of participants in the 2010 PPMI Summit agreed that “adjustment of medication regimens based on individual genetic characteristics is an essential pharmacist-provided drug therapy management service.”9 Notably, ASHP recently adopted a policy statement on the Pharmacist’s Role in Clinical Pharmacogenomics,10 supplementing policies, PPMI statements, textbooks, and an online resource center developed by the ASHP Section of Clinical Specialists and Scientists’ Advisory Group on Emerging Sciences.11