27th EAHP Congress - PRE-Evaluation and Learning Assessment Form:

CPS1 - Pharmacogenetic testing to optimise therapy

Speaker: Jesse J. Swen

ACPE UAN: 0475-0000-23-009-L04-P - A knowledge-based activity

The European Association of Hospital Pharmacists (EAHP) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
More information: https://www.eahp.eu/congresses/acpe

Self-assessment questions:

Question Title

* 1. For the European population, the chance of carrying a pharmacogenetic variant that requires a dose adjustment or change of therapy equals the chance of:

A delayed train (1 in 10 to 1 in 100)

Dutch world championship korfball (95%)

Other (please specify)

Question Title

* 2. A patient with esophageal cancer is treated with 5-FU. She dies within 3 weeks. Afterwards pharmacogenetic testing is performed. Which test result is most likely?

UGT1A1 poor metabolizer

DPD poor metabolizer

Other (please specify)

Question Title

* 3. The U-PGx PREPARE study assessed the clinical utility of pre-emptive pharmacogenetic panel testing. The results show that:

A 12-gene panel test lowers the risk for clinically relevant ADRs by 30% and is useful for all hospitalized patients

~25% of the tested patients carried an actionable variant for their index drug that required a dose adjustment or change of drug

Other (please specify)

CPS1 - Pharmacogenetic testing to optimise therapy

Link to EAHP Statements
Section 4 - Clinical Pharmacy: Statement - 4.1
Section 5 - Patient Safety and Quality Assurance: Statements - 5.1, 5.6

ACPE UAN: 0475-0000-23-009-L04-P - A knowledge-based activity

Abstract
Over the past decade it has become increasingly apparent that genetically controlled variations in drug disposition and response are important factors for drug efficacy and safety. Testing patients for pharmacogenomic variants allows healthcare providers to provide their patients with a more personalised drug therapy and thus achieving the optimal therapeutic response, avoiding therapeutic failure and minimising side effects and toxicity.

Two broad approaches of pharmacogenetic testing can be taken: a point of care testing in which genotyping for specific variants is undertaken at the time of drug prescription, and a pre-emptive approach in which pharmacogenetic testing is performed for multiple variants that are thought to affect drug response. The information is then archived for later use when a target drug is prescribed. For drugs with known pharmacogenetic variations guidelines have been developed in order to help clinicians understand how available genetic test results could be used to optimise drug therapy.

Despite clinical and scientific advances of pharmacogenetic testing, its application into routine clinical practice remains limited. Potential barriers that need to be overcome may include cost-effectiveness of the testing, ethical concerns over the use of DNA and lack of education.

During this seminar we will address the current state of implementation of pharmacogenetic testing, the rationale for both approaches, impact on the cost-effectiveness and obstacles that must be overcome.

Learning objectives
After the session the participants should be able to:

Define the benefits of pharmacogenetic testing
Define the factors which influence the potential effectiveness of pharmacogenomic testing
List the barriers for implementation of pharmacogenetic testing into clinical care

Educational need addressed
Hospital pharmacist knowledge and ability to understand and interpret genomic tests is important for optimisation of patient´s therapy.

Keywords: Adverse drug reactions, pharmacogenomics, pharmacogenetic testing, personalisation of therapy