Evaluation of a pharmacist-led pharmacogenomic service and provider acceptance at VA Puget Sound.

PURPOSE: Pharmacogenomic (PGx) testing provides genetic information that supports precision medicine use to improve efficacy and safety. A pharmacist-led PGx service was implemented to help providers manage drug-gene interactions.

SUMMARY: A pharmacist-led PGx service had PGx pharmacist conducted chart reviews to identify and make management recommendations for the drug-gene interactions, which were shared with relevant providers. A quality improvement project was performed to assess the effectiveness of implementation. PGx chart review notes written by pharmacy from May 2024 to November 2024 were reviewed. Ninety-eight patients were included in this project. After reviewing the PGx pharmacist's recommendations, providers managed 61% of the patients who had drug-gene interactions, where management was defined as a provider documenting their plans for the interactions in their notes. This is a significant improvement compared to pre-intervention data (from November 2023 to April 2024), where only 10% of interactions were managed by a provider. Not all drug-gene interactions (32%, 22/68) were associated with the specialty of the PGx ordering provider.

CONCLUSION

The pharmacist-led PGx service led to a six‑fold increase in healthcare provider-managed drug-gene interactions. The PGx pharmacist's recommendations increased providers' awareness of the drug-gene interactions.