WS6: Pharmacogenetics as a Tool for Clinical Pharmacists to Promote Precision Medicine in a Digitalized Environment

Francesca Wirth, Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
Luana Mifsud Buhagiar, Malta Medicines Authority, San Gwann, Malta
Anthony Serracino-Inglott, Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta

Background:

The goal of pharmacogenetics is to understand how an individual’s distinctive genetic composition can alter the pharmacokinetic and pharmacodynamic responses to drugs. Tailoring drug choice and dose according to pharmacogenetics has the potential to enhance therapeutic efficacy and decrease side-effects, with a resulting healthcare economic benefit. Pharmacogenetics is dynamic and is presently impacting on various important therapeutic areas due to a progressive rise in the number of clinically significant genetic polymorphisms being identified, more pharmacogenetic information being included in official drug labelling and digital support systems.1,2 By highlighting relevant pharmacogenetic aspects, pharmacists can contribute to individualisation of therapy.3

Target audience:

This workshop aims to highlight clinical significance and applications of pharmacogenetics, to describe skills relevant for the interpretation of pharmacogenetic information in official drug labelling and to identify electronic support structures which can be used as tools to personalise drug therapy.

Learning Objectives:

After participating in this workshop, the participants should be able to:
i. Recognise the clinical significance and applications of pharmacogenetics;
ii. Interpret pharmacogenetic information in product labels and guidance documents;
iii. Reflect on approaches clinical pharmacists may take in leading the implementation of pharmacogenetics and related informatics to enhance their practice.

Content and Structure:

The moderators will draw on their experience from practice and research in the field, to stimulate learning through real-world examples related to clopidogrel, simvastatin, and amitriptyline.4-6
Part 1
Plenary (0-40 min): Practical implications of pharmacogenetics including analytical considerations, actionable genotype-guided dosing recommendations and the clinical pharmacist oversight in managing a multidisciplinary approach to clinical implementation.
Part 2
Interactive presentation (40-70 min): Pharmacy informatics including overview on the IT framework in a hospital setting, combining genetic information with clinical data, educational models for healthcare professionals, mitigating alert fatigue, communication strategies and networking.
Part 3
Group task (70-100 min): Case-based activity, facilitated by moderators, focusing on the clinical application of pharmacogenetics in cardiology and psychiatry.
Part 4
Consolidation (100-120 min): Discussion on outcomes from group task and take-home messages.

References:
1. Klein ME, Masud Parvez MD, Shin JG. Clinical implementation of pharmacogenomics for personalised precision medicine: Barriers and solutions. J Pharm Sci. 2017;106:2368-2379.
2. Zdanowicz MM. Pharmacogenomics: Current and future promise. In: Zdanowicz MM. Concepts in Pharmacogenomics. Fundamentals and Therapeutic applications in Personalized medicine, 2nd ed. USA: ASHP; 2017.
3. Johnson JA. Pharmacists should jump onto the clinical pharmacogenetics train. Am J Health Syst Pharm. 2016; 73(23): 2013–16.
4. Wirth F, Zahra G, Xuereb RG, Barbara C, Fenech A, Azzopardi LM. Comparison of a rapid point-of-care and two laboratory-based CYP2C19*2 genotyping assays for personalisation of antiplatelet therapy. Int J Clin Pharm. 2016;38(2):414-20.
5. Cerdá Iñesta J, Wirth F, Zahra G, Xuereb RG, Barbara C, Serracino-Inglott A. Pharmacogenetic testing for personalisation of statin therapy. Eur J Hosp Pharm. 2019;26(Suppl 1): A211.
6. Mifsud Buhagiar L, Micallef B, Borg JJ, Vella H, Serracino Inglott A, LaFerla G. Regulatory sciences and translational pharmacogenetics: amitriptyline as a case in point. Drug Metab Pers Ther. 2019; in press.

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