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Establishment of a Pharmacogenetics Service Focused on Optimizing Existing Pharmacogenetic Testing at a Large Academic Health Center

Multiple groups have described strategies for clinical implementation of pharmacogenetics (PGx) that often include internal laboratory tests that are specifically developed for their implementation needs. However, many institutions are not able to follow this practice and instead must utilize extern...

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Autores principales: Pasternak, Amy L., Ward, Kristen M., Ateya, Mohammad B., Choe, Hae Mi, Thompson, Amy N., Clark, John S., Ellingrod, Vicki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711716/
https://www.ncbi.nlm.nih.gov/pubmed/33023029
http://dx.doi.org/10.3390/jpm10040154
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author Pasternak, Amy L.
Ward, Kristen M.
Ateya, Mohammad B.
Choe, Hae Mi
Thompson, Amy N.
Clark, John S.
Ellingrod, Vicki
author_facet Pasternak, Amy L.
Ward, Kristen M.
Ateya, Mohammad B.
Choe, Hae Mi
Thompson, Amy N.
Clark, John S.
Ellingrod, Vicki
author_sort Pasternak, Amy L.
collection PubMed
description Multiple groups have described strategies for clinical implementation of pharmacogenetics (PGx) that often include internal laboratory tests that are specifically developed for their implementation needs. However, many institutions are not able to follow this practice and instead must utilize external laboratories to obtain PGx testing results. As each external laboratory might have different ordering and reporting workflows, consistent reporting and storing of PGx results within the medical record can be a challenge. This might result in patient safety concerns as important PGx information might not be easily identifiable at the point of current or future prescribing. Herein, we describe initial PGx clinical implementation efforts at a large academic medical center, focusing on optimizing three different test ordering workflows and two distinct result reporting strategies. From this, we identified common issues such as variable reporting location and structure of PGx results, as well as duplicate PGx testing. We identified several opportunities to optimize our current processes, including—(1) PGx laboratory stewardship, (2) increasing visibility of PGx tests, and (3) clinician and patient education. Key to the success was the importance of engaging clinician, informatics, and pathology stakeholders, as we developed interventions to improve our PGX implementation processes.
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spelling pubmed-77117162020-12-04 Establishment of a Pharmacogenetics Service Focused on Optimizing Existing Pharmacogenetic Testing at a Large Academic Health Center Pasternak, Amy L. Ward, Kristen M. Ateya, Mohammad B. Choe, Hae Mi Thompson, Amy N. Clark, John S. Ellingrod, Vicki J Pers Med Article Multiple groups have described strategies for clinical implementation of pharmacogenetics (PGx) that often include internal laboratory tests that are specifically developed for their implementation needs. However, many institutions are not able to follow this practice and instead must utilize external laboratories to obtain PGx testing results. As each external laboratory might have different ordering and reporting workflows, consistent reporting and storing of PGx results within the medical record can be a challenge. This might result in patient safety concerns as important PGx information might not be easily identifiable at the point of current or future prescribing. Herein, we describe initial PGx clinical implementation efforts at a large academic medical center, focusing on optimizing three different test ordering workflows and two distinct result reporting strategies. From this, we identified common issues such as variable reporting location and structure of PGx results, as well as duplicate PGx testing. We identified several opportunities to optimize our current processes, including—(1) PGx laboratory stewardship, (2) increasing visibility of PGx tests, and (3) clinician and patient education. Key to the success was the importance of engaging clinician, informatics, and pathology stakeholders, as we developed interventions to improve our PGX implementation processes. MDPI 2020-10-03 /pmc/articles/PMC7711716/ /pubmed/33023029 http://dx.doi.org/10.3390/jpm10040154 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
Pasternak, Amy L.
Ward, Kristen M.
Ateya, Mohammad B.
Choe, Hae Mi
Thompson, Amy N.
Clark, John S.
Ellingrod, Vicki
Establishment of a Pharmacogenetics Service Focused on Optimizing Existing Pharmacogenetic Testing at a Large Academic Health Center
title Establishment of a Pharmacogenetics Service Focused on Optimizing Existing Pharmacogenetic Testing at a Large Academic Health Center
title_full Establishment of a Pharmacogenetics Service Focused on Optimizing Existing Pharmacogenetic Testing at a Large Academic Health Center
title_fullStr Establishment of a Pharmacogenetics Service Focused on Optimizing Existing Pharmacogenetic Testing at a Large Academic Health Center
title_full_unstemmed Establishment of a Pharmacogenetics Service Focused on Optimizing Existing Pharmacogenetic Testing at a Large Academic Health Center
title_short Establishment of a Pharmacogenetics Service Focused on Optimizing Existing Pharmacogenetic Testing at a Large Academic Health Center
title_sort establishment of a pharmacogenetics service focused on optimizing existing pharmacogenetic testing at a large academic health center
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711716/
https://www.ncbi.nlm.nih.gov/pubmed/33023029
http://dx.doi.org/10.3390/jpm10040154
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