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Assessing the Implementation of Pharmacogenomic Panel-Testing in Primary Care in the Netherlands Utilizing a Theoretical Framework

Despite overcoming many implementation barriers, pharmacogenomic (PGx) panel-testing is not routine practice in the Netherlands. Therefore, we aim to study pharmacists’ perceived enablers and barriers for PGx panel-testing among pharmacists participating in a PGx implementation study. Here, pharmaci...

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Autores principales: van der Wouden, Cathelijne H., Paasman, Ellen, Teichert, Martina, Crone, Matty R., Guchelaar, Henk-Jan, Swen, Jesse J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141350/
https://www.ncbi.nlm.nih.gov/pubmed/32192029
http://dx.doi.org/10.3390/jcm9030814
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author van der Wouden, Cathelijne H.
Paasman, Ellen
Teichert, Martina
Crone, Matty R.
Guchelaar, Henk-Jan
Swen, Jesse J.
author_facet van der Wouden, Cathelijne H.
Paasman, Ellen
Teichert, Martina
Crone, Matty R.
Guchelaar, Henk-Jan
Swen, Jesse J.
author_sort van der Wouden, Cathelijne H.
collection PubMed
description Despite overcoming many implementation barriers, pharmacogenomic (PGx) panel-testing is not routine practice in the Netherlands. Therefore, we aim to study pharmacists’ perceived enablers and barriers for PGx panel-testing among pharmacists participating in a PGx implementation study. Here, pharmacists identify primary care patients, initiating one of 39 drugs with a Dutch Pharmacogenetic Working Group (DPWG) recommendation and subsequently utilizing the results of a 12 gene PGx panel test to guide dose and drug selection. Pharmacists were invited for a general survey and a semi-structured interview based on the Tailored Implementation for Chronic Diseases (TICD) framework, aiming to identify implementation enablers and barriers, if they had managed at least two patients with actionable PGx results. In total, 15 semi-structured interviews were performed before saturation point was reached. Of these, five barrier themes emerged: (1) unclear procedures, (2) undetermined reimbursement for PGx test and consult, (3) insufficient evidence of clinical utility for PGx panel-testing, (4) infrastructure inefficiencies, and (5) HCP PGx knowledge and awareness; and two enabler themes: (1) pharmacist perceived role in delivering PGx, and (2) believed clinical utility of PGx. Despite a strong belief in the beneficial effects of PGx, pharmacists’ barriers remain, an these hinder implementation in primary care.
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spelling pubmed-71413502020-04-10 Assessing the Implementation of Pharmacogenomic Panel-Testing in Primary Care in the Netherlands Utilizing a Theoretical Framework van der Wouden, Cathelijne H. Paasman, Ellen Teichert, Martina Crone, Matty R. Guchelaar, Henk-Jan Swen, Jesse J. J Clin Med Article Despite overcoming many implementation barriers, pharmacogenomic (PGx) panel-testing is not routine practice in the Netherlands. Therefore, we aim to study pharmacists’ perceived enablers and barriers for PGx panel-testing among pharmacists participating in a PGx implementation study. Here, pharmacists identify primary care patients, initiating one of 39 drugs with a Dutch Pharmacogenetic Working Group (DPWG) recommendation and subsequently utilizing the results of a 12 gene PGx panel test to guide dose and drug selection. Pharmacists were invited for a general survey and a semi-structured interview based on the Tailored Implementation for Chronic Diseases (TICD) framework, aiming to identify implementation enablers and barriers, if they had managed at least two patients with actionable PGx results. In total, 15 semi-structured interviews were performed before saturation point was reached. Of these, five barrier themes emerged: (1) unclear procedures, (2) undetermined reimbursement for PGx test and consult, (3) insufficient evidence of clinical utility for PGx panel-testing, (4) infrastructure inefficiencies, and (5) HCP PGx knowledge and awareness; and two enabler themes: (1) pharmacist perceived role in delivering PGx, and (2) believed clinical utility of PGx. Despite a strong belief in the beneficial effects of PGx, pharmacists’ barriers remain, an these hinder implementation in primary care. MDPI 2020-03-17 /pmc/articles/PMC7141350/ /pubmed/32192029 http://dx.doi.org/10.3390/jcm9030814 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
van der Wouden, Cathelijne H.
Paasman, Ellen
Teichert, Martina
Crone, Matty R.
Guchelaar, Henk-Jan
Swen, Jesse J.
Assessing the Implementation of Pharmacogenomic Panel-Testing in Primary Care in the Netherlands Utilizing a Theoretical Framework
title Assessing the Implementation of Pharmacogenomic Panel-Testing in Primary Care in the Netherlands Utilizing a Theoretical Framework
title_full Assessing the Implementation of Pharmacogenomic Panel-Testing in Primary Care in the Netherlands Utilizing a Theoretical Framework
title_fullStr Assessing the Implementation of Pharmacogenomic Panel-Testing in Primary Care in the Netherlands Utilizing a Theoretical Framework
title_full_unstemmed Assessing the Implementation of Pharmacogenomic Panel-Testing in Primary Care in the Netherlands Utilizing a Theoretical Framework
title_short Assessing the Implementation of Pharmacogenomic Panel-Testing in Primary Care in the Netherlands Utilizing a Theoretical Framework
title_sort assessing the implementation of pharmacogenomic panel-testing in primary care in the netherlands utilizing a theoretical framework
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141350/
https://www.ncbi.nlm.nih.gov/pubmed/32192029
http://dx.doi.org/10.3390/jcm9030814
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