A pharmacy resident-driven virtual pharmacogenomics clinic: Utilizing population dashboard management tools to identify veterans who may benefit from testing.

Abstract

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Purpose: Expanding access to pharmacogenomics (PGx) testing to veterans has been an emphasis in the Veterans Health Administration (VHA); using population dashboard tools (PDTs) may identify additional patients who qualify for testing. Involving pharmacy residents in PGx can help prepare them for precision medicine practice and more efficiently provide PGx care to patients.

Methods: Veterans treated in the outpatient setting at the Lt. Col. Luke Weathers, Jr. Veterans Affairs (VA) Medical Center from March 2023 to June 2024 were included in this study. Upon creation of a virtual PGx clinic, a PGx PDT was used to identify patients newly prescribed medications on the VA PGx gene testing panel. The clinic was driven by a postgraduate year 2 pharmacy resident with a preceptor overseeing the practice, and patients were contacted for consent and testing. The number and type of PGx gene variants identified were assessed, with results discussed with patients and recommendations made to providers.

Results: A total of 130 patients were screened, of whom 104 had PGx testing, corresponding to an 80% consent rate. Overall, 247 PGx gene variants were identified, including 149 informational and 78 actionable drug-gene variants, 18 variants indicating inheritable conditions, and 17 variants corresponding to phenoconversion. A total of 90 recommendations were made to providers, and patients had an average of 2.3 PGx-impacted medications prescribed. Of the actionable drug-gene variants, the majority were related to use of clopidogrel, statins, sertraline, and proton pump inhibitors.

Conclusion: Novel use of a PDT was helpful in identifying patients qualifying for PGx testing. Creation of the resident-driven clinic resulted in PGx interventions for the majority of patients who underwent testing.