Implementation of a multidisciplinary pharmacogenomics clinic in a community health system

作者：Henry Mark Dunnenberger, Matthew Biszewski, Gillian Casey Bell, Annette Sereika, Holley May, Samuel G. Johnson, Peter J. Hulick, Janardan D. Khandekar · 发表于：American Journal of Health-System Pharmacy · 年份：2016 · DOI：10.2146/ajhp160072 · 被引用次数：124 · 研究领域：Pharmacogenetics and Drug Metabolism、Genomics and Rare Diseases、Blood disorders and treatments

PURPOSE: The development and implementation of a multidisciplinary pharmacogenomics clinic within the framework of an established community-based medical genetics program are described. SUMMARY: Pharmacogenomics is an important component of precision medicine that holds considerable promise for pharmacotherapy optimization. As part of the development of a health system-wide integrated pharmacogenomics program, in early 2015 Northshore University Health-System established a pharmacogenomics clinic run by a multidisciplinary team including a medical geneticist, a pharmacist, a nurse practitioner, and genetic counselors. The team identified five key program elements: (1) a billable-service provider, (2) a process for documentation of relevant medication and family histories, (3) personnel with the knowledge required to interpret pharmacogenomic results, (4) personnel to discuss risks, benefits, and limitations of pharmacogenomic testing, and (5) a mechanism for reporting results. The most important program component is expert interpretation of genetic test results to provide clinically useful information; pharmacists are well positioned to provide that expertise. At the Northshore University HealthSystem pharmacogenomics clinic, patient encounters typically entail two one-hour visits and follow a standardized workflow. At the first visit, pharmacogenomics-focused medication and family histories are obtained, risks and benefits of genetic testing are explained, and a test sample ...