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Review
. 2019 Aug 27;13(1):39.
doi: 10.1186/s40246-019-0229-z.

Translating pharmacogenomics into clinical decisions: do not let the perfect be the enemy of the good

Kristi Krebs  1   2 , Lili Milani  3
Affiliations
Review

Translating pharmacogenomics into clinical decisions: do not let the perfect be the enemy of the good

Kristi Krebs et al. Hum Genomics. .

Abstract

The field of pharmacogenomics (PGx) is gradually shifting from the reactive testing of single genes toward the proactive testing of multiple genes to improve treatment outcomes, reduce adverse events, and decrease the burden of unnecessary costs for healthcare systems. Despite the progress in the field of pharmacogenomics, its implementation into routine care has been slow due to several barriers. However, in recent years, the number of studies on the implementation of PGx has increased, all providing a wealth of knowledge on different solutions for overcoming the obstacles that have been emphasized over the past years. This review focuses on some of the challenges faced by these initiatives, the solutions and different approaches for testing that they suggest, and the evidence that they provide regarding the benefits of preemptive PGx testing.

Keywords: Clinical decision support; Implementation of pharmacogenetics; PGx; Pharmacogenetics; Pharmacogenomics; Translation into the clinic.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Current pharmacogenetic implementation initiatives. Colored points indicate different programs and consortia established for collaborative PGx implementation studies (details in Table 1)
Fig. 2
Fig. 2
Purchasing of drugs with CPIC guidelines based on the Electronic health records of 52,000 Estonian biobank participants. a The number of individuals who have purchased at least one drug listed in CPIC guidelines. Percentages are indicating the proportions from the total number of biobank participants (52,062). b The number of individuals with wild-type or normal function genotypes and drug purchases (light gold), and the proportion of individuals with high-risk genotypes (gray) of a gene covered by the CPIC guidelines. Numbers are represented for 23 drugs since the pipeline for calling metabolizing phenotypes was developed for 11 genes [44]
Fig. 3
Fig. 3
Current solutions and opportunities for overcoming some of the barriers of pharmacogenetic implementation
See this image and copyright information in PMC

References

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