Personalized medicine via Pharmacogenetics: Investigating critical success factors for clinical implementation

Background and aim: Pharmacogenetics (PGx) has the potential to improve drug efficacy and safety by identifying patients likely to respond well to a certain drug or who could be at risk. Although substantial evidence has been published to support the clinical use of PGx, clinical implementation is limited. The University Medical Center Groningen (UMCG) is developing a PGx implementation pilot. As a first step, we assessed impeding and facilitating factors as well as needs of pharmacists, prescribers and patients in applying PGx. Materials and Methods: Qualitative interview and focus group studies were conducted with 7 pharmacists, 13 prescribers and 19 patients. Results: Both professionals and patients were positive towards PGx. A lack in PGx knowledge among pharmacists and pre-scribers was, however, considered a barrier. For PGx implementation, clinical decision support was considered a prerequisite for prescribers. The distribution of responsibilities also needs addressing. Prescribers and pharmacists differed in views, both holding the other responsible. For patients the offer of an animation in addition to an information brochure aided in understanding PGx. Since the term PGx was found to be difficult, it was suggested to speak of personalized medication in the implementation process. Conclusions: A positive attitude towards clinical implementation of PGx was found. The availability of clinical decision support is regarded as a critical success factor. In the UMCG implementation pilot, PGx will be implemented within three departments of the UMCG (psychiatry, internal medicine, geriatrics) and clinical decision support software based on the GASTON® framework will be used and evaluated.