Development and implementation of a pharmacist-managed clinical pharmacogenetics service

被引:115
|
作者
Crews, Kristine R. [1 ,2 ]
Cross, Shane J. [2 ]
McCormick, John N. [2 ]
Baker, Donald K. [2 ,3 ]
Molinelli, Alejandro R. [4 ]
Mullins, Richard [4 ,5 ]
Relling, Mary V. [2 ,6 ]
Hoffman, James M. [1 ,2 ]
机构
[1] St Jude Childrens Res Hosp, Dept Pharmaceut, Translat Res Lab, Memphis, TN 38105 USA
[2] Univ Tennessee, Hlth Sci Ctr, Coll Pharm, Memphis, TN USA
[3] St Jude Childrens Res Hosp, Dept Informat Sci, Memphis, TN 38105 USA
[4] St Jude Childrens Res Hosp, Dept Pharmaceut, Clin Pharmacokinet Lab, Memphis, TN 38105 USA
[5] Childrens Healthcare Atlanta, Core Labs, Atlanta, GA USA
[6] Univ Tennessee, Hlth Sci Ctr, Coll Med, Memphis, TN USA
基金
美国国家卫生研究院;
关键词
Clinical pharmacists; Clinical pharmacy; Hospitals; Pharmaceutical services; Pharmacogenetics; S-METHYLTRANSFERASE DEFICIENCY; COST-EFFECTIVENESS ANALYSIS; THIOPURINE-METHYLTRANSFERASE; MERCAPTOPURINE METABOLISM; SEVERE TOXICITY; AZATHIOPRINE; GENOTYPE; THERAPY; POLYMORPHISMS; HETEROZYGOSITY;
D O I
10.2146/ajhp100113
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Purpose. The development and implementation of a pharmacist-managed clinical pharmacogenetics service are described. Summary. A pharmacist-managed clinical pharmacogenetics service was designed and implemented at an academic specialty hospital to provide clinical pharmacogenetic testing for gene products important to the pharmacodynamics of medications used in the hospital's patients. A series of accredited educational seminars were conducted for our pharmacists to establish competencies in providing pharmacogenetic consults for the genes to be tested by the clinical pharmacogenetics service. The service was modeled after and integrated with an already-established clinical pharmacokinetics service. A steering committee was formed to evaluate the use of available tests, new evidence for implementation of additional tests, and other service quality metrics. All clinical pharmacogenetic test results are first reported to one of the pharmacists, who reviews the result and provides a written consultation. The consultation includes an interpretation of the result and recommendations for any indicated changes to therapy. In 2009, 136 clinical pharmacogenetic tests were performed. The service has been met with positive clinician feedback. The successful implementation of this service highlights the leadership role that pharmacists can take in moving pharmacogenetics from research to patient care. Conclusion. The development of and experience with a pharmacist-managed clinical pharmacogenetics service are described. The program's success has depended on collaboration between the clinical laboratory and pharmacists, and pharmacists' pharmacogenetic recommendations have been well accepted by. prescribers.
引用
收藏
页码:143 / 150
页数:8
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