The challenges of implementing pharmacogenomic testing in the clinic

ABSTRACT

Introduction: Pharmacogenomic testing has the potential to greatly benefit patients by enabling personalization of medication management, ensuring better efficacy and decreasing the risk of side effects. However, to fully realize the potential of pharmacogenomic testing, there are several important issues that must be addressed.

Areas covered: In this expert review we discuss current challenges impacting the implementation of pharmacogenomic testing in the clinical practice. We emphasize issues related to testing methods, reporting of the results, test selection, clinical interpretation of the results, cost-effectiveness, and the long-term use of pharmacogenomic results in clinical practice. We identify opportunities and future directions to facilitate clinical implementation.

Expert commentary: Several key elements are necessary to optimally integrate pharmacogenomic testing into clinical practice. Collaborative efforts among laboratories are needed to improve standardization of testing and reporting of the results. Clinicians need educational opportunities to improve understanding of which test to order and how to interpret the results. The electronic health records and other clinical systems need to improve their storage of the pharmacogenomics test results and interoperability to facilitate the use of clinically actionable results to improve patient care.

KEYWORDS:

• Clinical practice
• genetic testing
• pharmacogenomics
• pharmacogenomic testing
• precision medicine

Acknowledgments

We gratefully acknowledge the assistance of Lucy Hodge with the preparation of the manuscript. We appreciate the support of the Personalized Genomics Laboratory and the Center for Individualized Medicine of Mayo Clinic.

Declaration of interest

PJ Caraballo has received funding from the NIH and NSF. These organizations did not have any participation in the production of this manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. A reviewer on this manuscript has disclosed that they work in a similar area of research (implementation of pharmacogenetics) and is supported by NIH funding. A reviewer on this manuscript has disclosed is CPIC director and provided the authors with some comments that were CPIC related.

Additional information

Funding

This manuscript was not funded.