Interprofessional approach in pharmacogenomics: A systematic review
DOI:
https://doi.org/10.46542/pe.2024.249.1523Keywords:
Interprofessional relation, Pharmacogenetics, PharmacogenomicsAbstract
Background: The expansion of pharmacogenomics for individualised therapy is slow. A multidisciplinary approach is critical for pharmacogenomics to achieve its full potential for optimising patient care. This systematic review aimed to determine the barriers, procedures, and benefits of using an interprofessional approach in the education and clinical practice of pharmacogenomics.
Methods This systematic review was conducted using PubMed, Scopus, and ScienceDirect databases. A PRISMA flowchart was used to conduct the systematic review.
Results: Seventeen of 236 manuscripts were included. The data were categorised into four major themes: interprofessional approaches, procedures, barriers, and benefits. Eight studies were on interprofessional education (IPE), and the rest were on interprofessional collaboration (IPC). The essential procedure addressed education, resources, and multidisciplinary clinical practice in patient selection/counselling, pharmacogenomic testing, and decision-making and implementation. Eleven barriers and four benefits were identified for IPE and IPC.
Conclusions: Barriers were identified in IPE (knowledge/skills, confidence, time, finance, and geographical problem), IPC (resources, communication, and ambiguity about pharmacogenomic services), and IPE/IPC (stereotypes of other professions). Essential collaborative procedures include educational strategies with interprofessional approaches, support systems, and implementation of clinical practices. The benefits of IPE and IPC include improved communication/interaction, knowledge/skills, and therapeutic outcomes. IPE also increased students’ confidence.
References
Auvinen, K. J., Räisänen, J., Voutilainen, A., Jyrkkä, J., Mäntyselkä, P., & Lönnroos, E. (2021). Interprofessional medication assessment has effects on the quality of medication among home care patients: Randomized controlled intervention study. Journal of the American Medical Directors Association, 22(1), 74–81. https://doi.org/10.1016/j.jamda.2020.07.007
Barbarino, J. M., Whirl-Carrillo, M., Altman, R. B., & Klein, T. E. (2018). PharmGKB: A worldwide resource for pharmacogenomic information. Wiley Interdisciplinary Reviews. Systems Biology and Medicine, 10(4), e1417. https://doi.org/10.1002/wsbm.1417
Calinski, D. M., Hoefer, C., & Kisor, D. (2021). An interprofessional education experience to promote the role of the pharmacist in precision medicine. Currents in Pharmacy Teaching & Learning, 13(10), 1370–1375. https://doi.org/10.1016/j.cptl.2021.07.017
Drozda, K., Pacanowski, M. A., Grimstein, C., & Zineh, I. (2018). Pharmacogenetic labeling of FDA-approved drugs: A regulatory retrospective. JACC: Basic to Translational Science, 3(4), 545–549. https://doi.org/10.1016/j.jacbts.2018.06.001
Empey, P. E., Stevenson, J. M., Tuteja, S., Weitzel, K. W., Angiolillo, D. J., Beitelshees, A. L., Coons, J. C., Duarte, J. D., Franchi, F., Jeng, L. J. B., Johnson, J. A., Kreutz, R. P., Limdi, N. A., Maloney, K. A., Owusu Obeng, A., Peterson, J. F., Petry, N., Pratt, V. M., Rollini, F., … Lee, C. R. (2018). Multisite investigation of strategies for the implementation of CYP2C19 genotype-guided antiplatelet therapy. Clinical Pharmacology and Therapeutics, 104(4), 664–674. https://doi.org/10.1002/cpt.1006
Formea, C. M., Nicholson, W. T., & Vitek, C. R. (2015). An inter-professional approach to personalized medicine education: One institution’s experience. Personalized Medicine, 12(2), 129–138. https://doi.org/10.2217/pme.14.63
Haidar, C. E., Hoffman, J. M., Gammal, R. S., Relling, M. V, & Crews, K. R. (2017). Development of a postgraduate year 2 pharmacy residency in clinical pharmacogenetics. American Journal of Health-System Pharmacy: AJHP: Official Journal of the American Society of Health-System Pharmacists, 74(6), 409–415. https://doi.org/10.2146/ajhp160174
Hlaváč, V., Holý, P., & Souček, P. (2020). Pharmacogenomics to predict tumor therapy response: A focus on ATP-binding cassette transporters and cytochromes P450. Journal of Personalized Medicine, 10(3). https://doi.org/10.3390/jpm10030108
Johnson, S. G., Shaw, P. B., Delate, T., Kurz, D. L., Gregg, D., Darnell, J. C., & Aquilante, C. L. (2017). Feasibility of clinical pharmacist-led CYP2C19 genotyping for patients receiving non-emergent cardiac catheterization in an integrated health system. Pharmacy Practice, 15(2), 946. https://doi.org/10.18549/PharmPract.2017.02.946
Kabbani, D., Akika, R., Wahid, A., Daly, A. K., Cascorbi, I., & Zgheib, N. K. (2023). Pharmacogenomics in practice: A review and implementation guide. Frontiers in Pharmacology, 14, 1189976. https://doi.org/10.3389/fphar.2023.1189976
Karpa, K., Lehman, E., Iskandarani, K., & Haidet, P. (2018). Discovering interprofessional competencies within a clinical pharmacology curriculum. Journal of Interprofessional Education & Practice, 12, 17–24. https://doi.org/10.1016/j.xjep.2018.05.001
Mroz, P., Michel, S., Allen, J. D., Meyer, T., McGonagle, E. J., Carpentier, R., Vecchia, A., Schlichte, A., Bishop, J. R., Dunnenberger, H. M., Yohe, S., Thyagarajan, B., Jacobson, P. A., & Johnson, S. G. (2021). Development and implementation of in-house pharmacogenomic testing program at a major academic health system. Frontiers in Genetics, 12, 712602. https://doi.org/10.3389/fgene.2021.712602
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ (Clinical Research Ed.), 372, n71. https://doi.org/10.1136/bmj.n71
Perwitasari, D. A., Baroroh, F., Dania, H., Faridah, I. N., Hidayati, A., Nurmaguphita, D., & Rahayu, P. P. (2023). Interprofessional education in pharmacogenomics: Perspective of pharmacy and nursing students. Journal of Advanced Pharmacy Education and Research, 13(2), 16-23. https://doi.org/10.51847/pi4GGRK1z0
Quesnelle, K. M., Bright, D. R., & Salvati, L. A. (2018). Interprofessional education through a telehealth team based learning exercise focused on pharmacogenomics. Currents in Pharmacy Teaching & Learning, 10(8), 1062–1069. https://doi.org/10.1016/j.cptl.2018.05.015
Rendell, T., Barnett, J., Scott, S., & Wright, D. (2022). Designing a theory and evidence informed pharmacogenomic testing service in community pharmacy in England. Research in Social & Administrative Pharmacy: RSAP, 18(10), 3831–3838. https://doi.org/10.1016/j.sapharm.2022.04.002
Rohrer Vitek, C. R., Abul-Husn, N. S., Connolly, J. J., Hartzler, A. L., Kitchner, T., Peterson, J. F., Rasmussen, L. V, Smith, M. E., Stallings, S., Williams, M. S., Wolf, W. A., & Prows, C. A. (2017). Healthcare provider education to support integration of pharmacogenomics in practice: The eMERGE Network experience. Pharmacogenomics, 18(10), 1013–1025. https://doi.org/10.2217/pgs-2017-0038
Smith, C. S., Fisher, A., Victorine, D., Brotman, A., Lowther, D., Hedt, J., Smith, D., Speroff, E., & Tivis, R. (2018). Creation and initial validation of a 360° Interprofessional Clinic Assessment Tool (IP-CAT) for pre-and post-licensure trainees. Journal of Interprofessional Education & Practice, 10, 92–98. https://doi.org/10.1016/j.xjep.2017.04.004
Stäuble, C. K., Jeiziner, C., Bollinger, A., Wiss, F. M., Hatzinger, M., Hersberger, K. E., Ihde, T., Lampert, M. L., Mikoteit, T., Meyer Zu Schwabedissen, H. E., & Allemann, S. S. (2022). A guide to a pharmacist-led pharmacogenetic testing and counselling service in an interprofessional healthcare setting. Pharmacy (Basel, Switzerland), 10(4), 86. https://doi.org/10.3390/pharmacy10040086
Stäuble, C. K., Lampert, M. L., Mikoteit, T., Hatzinger, M., Hersberger, K. E., & Meyer Zu Schwabedissen, H. E. (2021). Pharmacogenetic-guided antidepressant selection as an opportunity for interprofessional collaboration: A case report. Life (Basel, Switzerland), 11, 7. https://doi.org/10.3390/life11070673
Swart, M., Stansberry, W. M., Pratt, V. M., Medeiros, E. B., Kiel, P. J., Shen, F., Schneider, B. P., & Skaar, T. C. (2019). Analytical validation of variants to aid in genotype-guided therapy for oncology. The Journal of Molecular Diagnostics: JMD, 21(3), 491–502. https://doi.org/10.1016/j.jmoldx.2019.01.009
Swen, J. J., van der Wouden, C. H., Manson, L. E. N., Abdullah-Koolmees, H., Blagec, K., Blagus, T., Böhringer, S., Cambon-Thomsen, A., Cecchin, E., & Cheung, K.-C. (2023). A 12-gene pharmacogenetic panel to prevent adverse drug reactions: An open-label, multicentre, controlled, cluster-randomised crossover implementation study. The Lancet, 401(10374), 347–356. https://doi.org/10.1016/s0140-6736(22)01841-4
Van Heukelom, J., Morgan, J., Massmann, A., Jacobsen, K., Petry, N. J., Baye, J. F., Frear, S., & Schultz, A. (2023). Evolution of pharmacogenomic services and implementation of a multi-state pharmacogenomics clinic across a large rural healthcare system. Frontiers in Pharmacology, 14, 1274165. https://doi.org/10.3389/fphar.2023.1274165
Ward, K. M., Taubman, D. S., Pasternak, A. L., Burghardt, K. J., Ellingrod, V. L., & Parikh, S. V. (2021). Teaching psychiatric pharmacogenomics effectively: evaluation of a novel interprofessional online course. Journal of the American College of Clinical Pharmacy, 4(2), 176–183. https://doi.org/10.1002/jac5.1381
Weinstein, S., Carroll, J. C., Jukic, S., Mcgivney, M. S., & Klatt, P. (2020). Perspectives of a pharmacist‐run pharmacogenomic service for depression in interdisciplinary family medicine practices. Journal of the American College of Clinical Pharmacy, 3(2), 417–424. https://doi.org/10.1002/jac5.1175
Weitzel, K. W., Smith, D. M., Elsey, A. R., Duong, B. Q., Burkley, B., Clare-Salzler, M., Gong, Y., Higgins, T. A., Kong, B., Langaee, T., McDonough, C. W., Staley, B. J., Vo, T. T., Wake, D. T., Cavallari, L. H., & Johnson, J. A. (2018). Implementation of standardized clinical processes for TPMT testing in a diverse multidisciplinary population: Challenges and lessons learned. Clinical and Translational Science, 11(2), 175–181. https://doi.org/10.1111/cts.12533
Yehya, A., & Matalgah, L. (2021). Toward interprofessional education of pharmacogenomics: An interdisciplinary assessment. Pharmacology, 106(9–10), 534–541. https://doi.org/10.1159/000517385
