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PHARMACOGENETICS: THE NEXT CHALLENGE FOR PHARMACY?
Clemerson JP, Payne K, Bissell P, Anderson C.
Centre for Pharmacy, Health and Society, University of Nottingham, University
Park, Nottingham, NG7 2RD. paxjpc@nottingham.ac.uk
Introduction
The latter half of the 20th century witnessed significant advances
in scientific understanding of the link between a person's genes and their
response to medication. The term 'pharmacogenetics' was first used to
describe clinical observations of inherited difference in response to
medicines in the 1950s. It has been suggested that pharmacogenetics may
be one area where the profession of pharmacy can play an important role
in terms of providing information to the public and the development of
new services. The aim of this study is to find out what community pharmacists
currently understand about developments in pharmacogenetic testing technologies
and what they predict to be the effects of these on their practice.
Method
Ten in-depth semi-structured qualitative interviews were conducted
with community pharmacists working in a variety of commercial and organisational
environments. An interview guide was developed based on findings from
the literature. Interview topics included pharmacists' experiences of
extending their roles in a community setting, and the opportunities and
barriers presented to them when doing so. Respondents were asked to describe
what they currently know about pharmacogenetics, they were then given
a short definition of pharmacogenetics and some of its future implications
and invited to consider the possible implications for their practice.
The interviews were audio-taped and transcribed verbatim and analysed
using the constant comparative technique to identify emerging themes.
Results
All pharmacists had limited knowledge of pharmacogenetics and emerging
technologies in this field. After considering the information given to
them regarding pharmacogenetics and its potential implications, the majority
of respondents in this study expressed positive opinions about their ability
to become involved in offering services in this area when the technology
becomes available in primary care. However, all found it hard to visualise
what their precise role may be. All respondents mentioned barriers which
may limit any potential role expansion within pharmacogenetics. These
included time and financial pressures, staffing issues, supervision and
personal control and training and competence issues.
Conclusion
Pharmacists had little knowledge of pharmacogenetics, suggesting that
strategies to engage practicing pharmacists in this field are needed.
It is not surprising that respondents found it difficult to envisage potential
opportunities for pharmacists to become involved in pharmacogenetics considering
this low level of knowledge, though promising that optimism was expressed
for potential role extension in this area. Preparing pharmacists for the
demands of pharmacogenetics and associated testing services must involve
more than simply the acquisition of knowledge on this subject. Greater
access to patients' medical records and increased collaboration with prescribers
will be essential.
Presented at the HSRPP Conference 2006, Bath
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