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Roseann S Gammal, Elizabeth Fieg, Pharmacist and genetic counselor collaboration in pharmacogenomics, American Journal of Health-System Pharmacy, Volume 79, Issue 18, 15 September 2022, Pages 1516–1520, https://doi.org/10.1093/ajhp/zxac168
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The goal of pharmacogenomic testing is to optimize medication-related outcomes using genetic data. Although pharmacogenomics has been successfully implemented into clinical practice in different ways, a common thread across practice settings is pharmacist involvement. It is well established that pharmacists, as the medication experts, are the logical leaders in the clinical application of pharmacogenomics.1-3 Indeed, many of the nation’s clinical pharmacogenomics programs have been developed and led by pharmacists.4-7 Educational standards in genomics for pharmacists, unlike those for any other healthcare professional, include detailed clinical pharmacogenomics competencies.8 However, the value of interprofessional collaboration in pharmacogenomics to enhance patient care cannot be understated. For example, partnerships with prescribers, informatics personnel, and clinical laboratory specialists can support the clinical implementation of pharmacogenomics.9 Although less frequently discussed in the pharmacogenomics implementation literature, genetic counselors can also have important roles in the provision of clinical pharmacogenomics services in collaboration with pharmacists.
A genetic counselor is a healthcare professional with advanced training in medical genetics and counseling who provides information and support to patients considering or undergoing genetic testing. A genetic counselor’s expertise in clinical genetic testing, risk assessment, and associated patient education nicely complement a pharmacist’s knowledge of genetic contributors to drug response and ability to create evidence-based pharmacotherapy care plans. Although there is currently limited coverage of pharmacogenomics concepts in genetic counseling master’s degree programs and a recognized need for improved genetic counselor education and training in this area,10 a genetic counselor’s skill set can be easily transferred to a clinical pharmacogenomics setting when the genetic counselor is partnered with a pharmacist. Previously published literature has theorized about this synergistic relationship, although few studies have illustrated its real-world application.11,12 Here we describe how a clinical pharmacist with specialized residency training in pharmacogenomics collaborates with a genetic counselor in the provision of clinical pharmacogenomics services at an academic medical center. Examples of collaborative counseling are illustrated using patient cases. This practice model capitalizes on the strengths of each profession to provide comprehensive patient care that lives at the intersection of pharmacology and genomics.
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