Defining Core Functions and Forms for the Implementation of Pharmacogenomics Testing in Primary Care

Pharmacogenomics (PGx), utilizing a patient's DNA to individualize medication prescribing, minimizes adverse events and improves patient outcomes. However, the integration of PGx into primary care remains sparse. PGx testing encompasses multiple components and can be considered a complex health intervention. We conducted an in-person workshop with early adopters from the Pharmacogenomics Global Research Network Implementation Working Group, followed by qualitative interviews with key opinion leaders, to identify the core functions and forms necessary for implementing PGx testing in primary care. Workshop participants agreed on six core functions necessary to implement PGx-guided medication prescribing in primary care settings: patient identification, test ordering, laboratory testing, returning results, providing medication recommendations, and modifying pharmacotherapy. An additional function, leadership engagement, was proposed by key opinion leaders. There was considerable variation in the forms, depending on local context and available resources. In this position paper, we discuss why it is critical to separately define the core functions required to implement PGx testing in primary care settings and the customizable forms used for local execution. Defining core functions provides an actionable first step to guide scalable and context-sensitive integration of PGx testing into routine primary care practice, balancing the need for both fidelity and adaptation in real-world implementation.