Pharmacogenetic (PGx) testing is a type of genetic test that assesses a patient’s risk of an adverse response or likelihood to respond to a given drug, informing drug selection and dosing.
As a pillar of the personalized medicine movement, PGx testing is anticipated to be important across all medical specialties,2 but particularly in primary care, where the majority of all drug prescriptions are written. It has been estimated that many of the drugs commonly prescribed by primary care practitioners (PCPs) such as fluoxetine, metoprolol, warfarin, and simvastatin are affected by PGx variation. Although several different strategies of delivering PGx testing have been proposed or are being investigated,6–8 at present, there is little clarity on which health professionals should order PGx testing, at what stage during treatment testing should be ordered, how best to communicate results to patients, and where results should be stored to inform future therapeutic decision making. Patients prefer receiving PGx test results from a familiar provider whom they trust such as a PCP; however, several factors have contributed to the slow integration of PGx testing in the primary care setting, including limited time as well as familiarity and experience with PGx testing. Because PGx testing is a relatively new field and many PCPs are unfamiliar with many of the basic tenets of the field, ongoing learning opportunities and/or faculty development would enable PCPs to feel more comfortable with the topic, and presumably engage in more effective communication with patients, and more appropriate use of testing. This paper suggests key elements to be discussed with patients prior to testing and when reporting test results to assist PCPs while recognizing some of the practical limitations in the primary care setting.
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