Implementing a Pharmacist-Led Primary Care Pharmacogenomics Medication Management Service.

Innovations in pharmacy Pub Date : 2024-05-31 eCollection Date: 2024-01-01 DOI:10.24926/iip.v15i2.6178
Kathryn Taylor, Audrey Umbreit, Catherine Lea, Emily Holm, Kimberly Kosloski Tarpenning
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Abstract

Background: Pharmacogenomics (PGx) is a tool to guide optimal medication selection. Increased demand for personalized medicine and the growing occurrence of chronic diseases are drivers for pharmacogenomic medication management services. A review of implementation models identified a paucity of models delivering these services utilizing pharmacists in primary care. Lack of standardization of this process remains a barrier to widespread implementation within health systems. Purpose: Describe the process of developing an institutional guidance document and applying it to implement a pharmacogenomics medication management service at clinic sites within an integrated health system in the United States. Measure the growth in the number of PGx visits completed. Method: A task force of pharmacists reviewed literature, guidelines, and institutional policies to create a comprehensive guidance document. The document included six minimum practice requirements for implementation in the primary care setting, and six additional recommendations. A retrospective chart review of all face to face, phone and eConsult PGx visit types occurring from January 1, 2022 through September 30, 2022 was conducted. Results: A pharmacist-led pharmacogenomics medication management service is now offered at all primary care sites within the health system. During the study timeframe, 1378 patients had a PGx visit, resulting in 1939 PGx visits. Of those visits, 1777 (92%) were referred by a primary care provider and 1675 (86.7%) were conducted by a primary care pharmacist. Twenty-nine primary care pharmacists offered the PGX service and 25 (89%) completed at least one visit. Patients were referred by providers from 56 of the 64 (87.5%) primary care departments. Conclusions: Developing an institutional process and guidance document for the implementation of a new pharmacist-led pharmacogenomics medication management service at clinic sites within an integrated health system was beneficial in developing and standardizing the workflow. Dissemination of workflow expectations to the primary care providers and pharmacists resulted in adoption of the service.

实施以药剂师为主导的基层医疗药物基因组学用药管理服务。
背景:药物基因组学(PGx)是指导最佳药物选择的工具。个性化医疗需求的增加和慢性病发病率的上升是药物基因组学药物管理服务的驱动力。对实施模式的审查发现,在初级保健中利用药剂师提供这些服务的模式很少。这一过程缺乏标准化仍然是在医疗系统内广泛实施的障碍。目的:描述制定机构指导文件的过程,并将其应用于在美国综合医疗系统内的诊所实施药物基因组学药物管理服务。衡量已完成的 PGx 访问次数的增长情况。方法:由药剂师组成的特别工作组对文献、指南和机构政策进行了审查,以制定一份全面的指导文件。该文件包括在初级医疗环境中实施的六项最低实践要求和另外六项建议。对 2022 年 1 月 1 日至 2022 年 9 月 30 日期间发生的所有面对面、电话和 eConsult PGx 访问类型进行了回顾性病历审查。结果目前,医疗系统内的所有初级保健机构都提供由药剂师主导的药物基因组学药物管理服务。在研究期间,1378 名患者接受了药物基因组学检查,共进行了 1939 次药物基因组学检查。其中,1777 人(92%)由初级医疗服务提供者转介,1675 人(86.7%)由初级医疗药剂师实施。29 名初级保健药剂师提供了 PGX 服务,其中 25 人(89%)至少完成了一次就诊。在 64 个初级医疗部门中,有 56 个(87.5%)的医疗服务提供者转介了患者。结论为在综合医疗系统内的诊所实施以药剂师为主导的新药物基因组学药物管理服务制定机构流程和指导文件,有利于制定和规范工作流程。向初级医疗服务提供者和药剂师宣传工作流程的期望值可促进服务的采用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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