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It’s often the case that those in the midst of revolutionary times don’t really see how fundamentally the world around them is changing until long after the changes have occurred. So let’s start by declaring that the revolution has begun: Genomic research will dramatically transform both the practice of pharmacy and the way patients are treated with medications for many diseases.
The sequencing of the human genome was a huge scientific breakthrough, and it’s spawning additional breakthroughs as genetic testing labs spring up and the cost of testing individual patients for their ability to metabolize a particular drug drops to affordable levels for health plan payers.
A patient can now submit to a buccal swab by a pharmacist or even, in some cases, just spit in a cup. The saliva sample is sent to a lab for genetic profiling and identification of a particular gene or enzyme that will guide the pharmacist and prescribing physician to what the American Pharmacists Association calls “a new patient-specific parameter” in medication therapy. Since patients don’t respond to many drugs the same way — and a significant percentage of them can’t even tolerate some medications because their particular genetic traits create different metabolic pathways for some meds — the result will be fewer adverse drug reactions and more targeted and more effective drug therapies.
“Discoveries in genomics relevant to medication selection and management are advancing exponentially,” the APhA reports. “Genomic discoveries provide the basis for the evolution of offering care tailored to the genetic makeup of the individual — an approach that has come to be known as personalized medicine.”
Pharmacists, says the APhA, “have a tremendous opportunity to lay claim to the field.”
Look for a longer story from me about the exploding field of pharmacogenomics in the next issue of Collaborative Care magazine, a publication of the Drug Store News Group. And please take a few moments to share your own take on the science and its impact on pharmacy. If you’re a student, do you feel you’re getting the classroom and lab preparation to become proficient in this kind of personalized patient care? And if you’re already a practicing pharmacist, are you already seeing changes in some patients’ medication therapy based on genomics?