Development of a Multifaceted Program for Pharmacogenetics Adoption at an Academic Medical Center: Practical Considerations and Lessons Learned

IF 6.3 2区 医学 Q1 PHARMACOLOGY & PHARMACY
Tyler Shugg, Emma M. Tillman, Amy M. Breman, Jennelle C. Hodge, Christine A. McDonald, Reynold C. Ly, Elizabeth J. Rowe, Wilberforce Osei, Tayler B. Smith, Peter H. Schwartz, John T. Callaghan, Victoria M. Pratt, Sheryl Lynch, Michael T. Eadon, Todd C. Skaar
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Abstract

In 2019, Indiana University launched the Precision Health Initiative to enhance the institutional adoption of precision medicine, including pharmacogenetics (PGx) implementation, at university-affiliated practice sites across Indiana. The overarching goal of this PGx implementation program was to facilitate the sustainable adoption of genotype-guided prescribing into routine clinical care. To accomplish this goal, we pursued the following specific objectives: (i) to integrate PGx testing into existing healthcare system processes; (ii) to implement drug–gene pairs with high-level evidence and educate providers and pharmacists on established clinical management recommendations; (iii) to engage key stakeholders, including patients to optimize the return of results for PGx testing; (iv) to reduce health disparities through the targeted inclusion of underrepresented populations; (v) and to track third-party reimbursement. This tutorial details our multifaceted PGx implementation program, including descriptions of our interventions, the critical challenges faced, and the major program successes. By describing our experience, we aim to assist other clinical teams in achieving sustainable PGx implementation in their health systems.

Abstract Image

在学术医学中心制定药物遗传学应用的多方面计划:实际考虑因素与经验教训。
2019 年,印第安纳大学发起了 "精准健康倡议",以加强精准医疗的机构采用,包括在印第安纳州各大学附属实践点实施药物遗传学 (PGx)。该 PGx 实施计划的总体目标是促进基因型指导处方在常规临床护理中的可持续应用。为实现这一目标,我们努力实现以下具体目标:(i) 将 PGx 检测纳入现有的医疗保健系统流程;(ii) 实施具有高水平证据的药物基因配对,并就既定的临床管理建议对医疗服务提供者和药剂师进行教育;(iii) 让包括患者在内的主要利益相关者参与进来,以优化 PGx 检测结果的回报;(iv) 通过有针对性地纳入代表性不足的人群来减少健康差异;(v) 跟踪第三方报销情况。本教程详细介绍了我们多方面的 PGx 实施计划,包括我们的干预措施、面临的关键挑战和计划的主要成功之处。通过介绍我们的经验,我们旨在帮助其他临床团队在其医疗系统中实现可持续的 PGx 实施。
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来源期刊
CiteScore
12.70
自引率
7.50%
发文量
290
审稿时长
2 months
期刊介绍: Clinical Pharmacology & Therapeutics (CPT) is the authoritative cross-disciplinary journal in experimental and clinical medicine devoted to publishing advances in the nature, action, efficacy, and evaluation of therapeutics. CPT welcomes original Articles in the emerging areas of translational, predictive and personalized medicine; new therapeutic modalities including gene and cell therapies; pharmacogenomics, proteomics and metabolomics; bioinformation and applied systems biology complementing areas of pharmacokinetics and pharmacodynamics, human investigation and clinical trials, pharmacovigilence, pharmacoepidemiology, pharmacometrics, and population pharmacology.
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