Contents
Introduction
Pharmacy professionals are experts in medicines with a background of scientific training and can significantly contribute to the impact of genomics on healthcare delivery. The term pharmacy professionals includes both pharmacists and pharmacy technicians, but the authority for certain roles may be delegated to members of the wider pharmacy team.
It is important that pharmacy professionals are acknowledged as key stakeholders in the implementation, delivery, and evaluation of genomic services.
Pharmacy professionals are skilled at interpreting complex scientific data and use evidence-based medicine to support shared decision-making in their established patient-facing roles within the multidisciplinary team (MDT). As a result, they are well-placed to perform key roles related to genomic medicine by supporting patient understanding, maximising the benefits of precision medicine across the integrated care system, and to play a key role in genomics implementation in healthcare.
Genomics in healthcare
Genomics is the study of an organism’s complete set of genetic information and how this knowledge can be applied. 1,2
Genomic medicine involves performing genomic tests (sometimes referred to as genetic tests) to identify changes in an individual’s DNA, RNA, genes, chromosomes, or proteins which can be used to tailor their clinical care.3 Genomic testing can be used in disease screening, diagnosis or to make treatment decisions. When used to inform treatment decisions, genomic medicine is an example of precision medicine.
Genomics is currently influencing the management of certain medical conditions and is set to expand to many other clinical areas in future healthcare.4
Pharmacogenomics (PGx) is just one aspect of genomics. Pharmacogenomics involves performing a genomic test to determine how an individual is predicted to respond to a medicine.5
Whilst pharmacy professionals have leading roles in the implementation and delivery of pharmacogenomics within medicines optimisation services, their roles in genomic medicine should not be limited to pharmacogenomics.
Established pharmacy roles in genomics and future potential for pharmacy professionals
Pharmacy professionals in the UK have already established roles in the application of genomic medicine in some areas of clinical practice, such as antimicrobial stewardship and infectious disease, cancer care and the management of certain genetic conditions such as monogenic diabetes and cystic fibrosis (CF).
The pharmacy professions believe that the future role of pharmacy in genomics should be expanded to both lead and support relevant aspects of genomic implementation across all healthcare sectors, as outlined in the Genome UK strategy produced by the UK Government and the implementation plans published by the devolved nations.6,7,8 Furthermore, the Royal College of Physicians in partnership with the British Pharmacology Society recognise that pharmacists are a key part of MDTs in the implementation and delivery of pharmacogenomics in their Personalised Prescribing document.9
Pharmacy professionals have the skills and expertise to apply the practice of genomic medicine across all sectors. The following roles are examples of how pharmacy professionals are currently fulfilling or could fulfil genomic responsibilities in the current UK healthcare system design.
These illustrative examples do not limit the future potential impact that pharmacy professionals could have on all aspects of genomic service delivery as key members and leaders within the wider multidisciplinary team.