Personal DNA Testing Increases Pharmacy Students' Confidence and Competence in Pharmacogenomics

Mahfoud Assem, PhD; Ulrich Broeckel, MD; George E. MacKinnon, PhD

Am J Pharm Educ. 2021;85(4):8249

Conclusion

Our study supports the use of a combination of didactic lectures, practice laboratory counseling activities, and student-led group discussions, coupled with student-specific personal pharmacogenomics testing, to improve pharmacy students' learning, interest, confidence, and perceptions in learning pharmacogenomics. An innovative teaching structure that includes undergoing a pharmacogenomics assay and reviewing and sharing their results with classmates will help prepare future pharmacists with the skills, competencies, and confidence to incorporate pharmacogenomics into future pharmacy practice.

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Acknowledgments
We are very grateful to all our student pharmacists who willingly and enthusiastically participated in this study; Mathew Letizia, PharmD, first year director of Professional Laboratories, for collaborative engagement; Erin Walcheske, Joel P. Spiess, and Sarah Fittanto for management and distribution of the survey and consent forms; and Aaron N. Winn, PhD, for statistical support.
Funding for this study was received from RPRD Diagnostics, LLC, Milwaukee, WI, and from the Medical College of Wisconsin School of Pharmacy.

Table 1. Pharmacy Students' Understanding of Basic Pharmacogenomics and the Role of the Pharmacist in Personalized Medicine
Survey question	Pre-Survey Mean (SD)	Post-Survey Mean (SD)
The risks of pharmacogenomic testing	2.6 (1.2)	3.8 (0.8)
The benefits of pharmacogenomic testing	2.9 (1.2)	4.1 (0.7)
How to interpret pharmacogenomic testing results	1.8 (0.8)	3.7 (0.7)
How pharmacogenomic test results are used in clinical practice	2.4 (1.0)	3.9 (0.7)
The purpose of preemptive pharmacogenomic testing	2.4 (1.1)	4.1 (0.7)
The purpose of reactive pharmacogenomic testing	2.2 (1.1)	4.0 (0.7)
The role of pharmacists in collecting patient samples/specimens for pharmacogenomic testing	2.2 (1.1)	3.9 (0.8)
The role of pharmacists in interpreting pharmacogenomic testing results	2.1 (1.0)	4.0 (0.7)

Survey questions were evaluated using a five-point Likert scale: 1=no understanding, 2=little understanding, 3=average understanding, 4=above average understanding, and 5=thorough understanding
All individual questions used a paired Wilcoxon signed-rank test to generate p values
All results are significant at a p<.001

Table 2. Pharmacy Students' Confidence in Conducting Different Aspects of Pharmacogenomics Consulting
Survey question	Pre-Survey Mean (SD)	Post-Survey Mean (SD)
How confident would you feel explaining pharmacogenomic test results to a patient?	1.8 (0.9)	3.8 (0.7)
How confident would you feel discussing pharmacogenomic test results with physicians and other prescribers?	1.7 (1.0)	3.8 (0.7)
How confident would you feel modifying a patient's medications (that may include changing a medication) based on pharmacogenomic test results?	1.9 (0.9)	3.6 (0.7)

Survey questions were evaluated using a 5-point Likert scale: 1=extremely not confident, 2=not confident, 3=neutral, 4=confident, and 5=extremely confident
All individual questions used a paired Wilcoxon signed-rank test to generate p values
All results are significant at the p<.001
SD=Standard deviation

Table 3. Pharmacy Students' Perception of the Usefulness of Pharmacogenomics Testing
Survey question	Pre-Survey Mean (SD)	Post-Survey Mean (SD)
In general, how useful do you feel pharmacogenomic testing will be in the clinical setting?	4.0 (1.3)	4.5 (0.7)
In general, how useful do you feel pharmacogenomic testing will be in the pharmacy setting?	3.8 (1.4)	4.4 (0.7)
In general, how useful do you feel pharmacogenomic test results are to the pharmacist's care of patients?	3.8 (1.5)	4.5 (0.7)

Survey questions were evaluated using a 5-point Likert scale: 1=extremely not useful, 2=not useful, 3=neutral, 4=useful, and 5=extremely useful
All individual questions used a paired Wilcoxon signed-rank test to generate p values
All results were not significant
SD=standard deviation

Table 4. Pharmacy Students' Comfort Level Regarding Their Future Readiness in Pharmacogenomics Prescription, Analysis, and Counseling
Survey question	Pre-Survey Mean (SD)	Post-Survey Mean (SD)
I would feel comfortable ordering pharmacogenomic testing	2.8 (1.2)	3.7 (0.6)^a
I would feel comfortable explaining the process of pharmacogenomic testing to patients	2.4 (1.0)	4.0 (0.6)^a
I would feel comfortable discussing pharmacogenomic test results with patients	2.2 (1.0)	4.0 (0.6)^a
I believe that pharmacogenomic testing is critical for determining appropriate healthcare	3.3 (1.1)	4.0 (0.7)^a
I would feel comfortable discussing genetics in general with patients	2.9 (1.0)	3.9 (0.7)^a
I believe that pharmacogenomic testing is critical for determining appropriate medication selection and regimens (dose and frequency) in patients	3.4 (1.1)	3.9 (0.6)^b
I would feel comfortable discussing pharmacogenomic test results with physicians and other prescribers	2.3 (1.0)	3.8 (0.6)^a
I would feel comfortable modifying a patient's medications (that may include changing a medication) based on pharmacogenomic test results	2.3 (1.1)	3.8 (0.7)^a
Pharmacogenomics is an integral part of the pharmacy profession	3.4 (1.0)	4.0 (0.7)^a
Pharmacogenomics may be an integral part of my practice as a pharmacist	3.5 (1.0)	4.0 (0.7)^a
I may encounter pharmacogenomics-related questions during my practice as a pharmacist	3.6 (0.0)	4.0 (0.6)^b
Post-graduation, I intend to read up on pharmacogenomics especially on how it influences my practice and/or specialty	3.6 (1.0)	3.9 (0.6)
Pharmacogenomics is a useful tool that pharmacists and medical professionals can use to optimize medication efficacy and/or prevent adverse events	3.8 (0.9)	4.1 (0.6)

Survey questions were evaluated using a 5-point Likert scale: 1=strongly disagree, 2=disagree, 3=neither disagree or agree, 4=agree, and 5=strongly agree
All individual questions used a paired Wilcoxon signed-rank test to generate p values
^a p<.001
^b p<.05