Knowledge, Attitudes and Education of Pharmacists Regarding Pharmacogenetic Testing

Mary W Roederer; Marcia Van Riper; John Valgus; George Knafl; Howard McLeod

Disclosures

Personalized Medicine. 2012;9(1):19-27. 

In This Article

Discussion

Pharmacists have long been thought of as the medication experts in the healthcare field. It has become evident over the past decade that pharmacogenetics is evolving into an essential tool to ensure optimal medication use in a growing number of medications and disease states. Therefore, it is imperative that pharmacists are prepared to use pharmacogenetic information to appropriately individualize medication therapy for patients now and in the future. The pharmacist serves many roles in the implementation of pharmacogenetics in the healthcare setting.[15] These include serving as a clinician who ensures that all proper information is incorporated into medication decisions, including pharmacogenetics. Pharmacists also serve as educators for patients and healthcare professionals alike to raise awareness of pharmacogenetics principles and clinical utilization strategies. Finally, pharmacists are in the optimal role to investigate and advance the science of pharmacogenetics through pilot and comparative–effectiveness research.

A survey on attitudes towards pharmacogenetics was recently reported for the US public.[16] This survey was conducted by telephone to over 2000 randomly identified participants throughout the US. The study achieved a 42% response rate and demonstrated a high rate of interest in pharmacogenetic testing, which could predict side effects, guide dosing, or assist with medication selection. Most were not willing to undergo testing, though, if there was a risk that their information could be shared without their permission. To date, there has been no formal analysis of practicing pharmacists' knowledge and attitudes of pharmacogenetics information. Our report is the first such survey that examines not only the pharmacists' perceived knowledge but attempts to measure actual knowledge through several questions related to pertinent genetic and pharmacogenetic information. We also explored attitudes towards pharmacogenetic information being used in clinical practice as well as thoughts on how pharmacists could best obtain further pharmacogenetics education.

Not surprisingly, over half of practicing pharmacists have received some formal training in genetics. Approximately a half of those who did respond as having formal genetics education, had genetics as part of their undergraduate curriculum, which presumably did not contain any content on pharmacogenetics. It was not until 2007, that the American Council on Pharmacy Accreditation set pharmacogenetics as a required component of the pharmacy curriculum.[103] The majority of participants in this survey have been in practice for over 10 years so the likelihood of receiving pharmacogenetics as part of the pharmacy curriculum is unlikely. Providing continuing education opportunities in pharmacogenetics has been a major focus of many colleges of pharmacy as well as many national pharmacy organizations. Only 14% of respondents had received any pharmacogenetics training through continuing education programs.

With a lack in formalized education in pharmacogenetics, it is not surprising that the majority of respondents reported their understanding of pharmacogenetics as fair or poor (83%). Only 17% of respondents rated their understanding of pharmacogenetics as excellent, very good or good. Those participants who rated their knowledge as either excellent or very good were associated with the highest mean scores on knowledge assessment, which helps validate this perception as being accurate. One encouraging statistic was that those with less than 10 years of practice experience demonstrated the highest scores on pharmacogenetic knowledge assessment, which may represent the increased focus of pharmacogenetics in the pharmacy curricula across the nation, as well as the increased amount of information on pharmacogenetics over the past decade. Of note, this group of practitioners with less than 10 years of experience also had the highest level of interest in further pharmacogenetics education.

In a similar survey of pharmacists that practice at three sites for the Mayo Clinic (in Arizona [AZ, USA], Florida [FL, USA] and Minnesota [MN, USA]), the authors conclude that pharmacists are interested to know about pharmacogenetics, feel pharmacogenetics contributes to the practice of pharmacy, but they feel ill-prepared to act on the results of pharmacogenetic tests. The survey responses suggest that practicing pharmacists need additional educational offerings to teach them about the application of pharmacogenetics.[17]

There are several limitations of our survey that may have impacted the type and validity of the results. First, the sample size is relatively small compared with the number of pharmacists practicing in the state of NC and throughout the USA. This is evidenced and compounded by our low response rate of 7.7%. With nearly 10,000 pharmacists with an active NC license, our survey population may not be reflective of the average pharmacist licensed in NC nor the USA.

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