Clinical Translational Science – One of the challenges hindering genomic implementation is the limited data on the outcomes and cost‐effectiveness of genotype‐guided drug therapy. The IGNITE network, consisting of institutions funded in the network and affiliate members, includes a number of institutions that have implemented pharmacogenetic testing to assist with prescribing decisions.
Advances in Chronic Kidney Disease – Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease. Thus, patients with CKD often require treatment with cardiovascular drugs, such as antiplatelet, antihypertensive, anticoagulant, and lipid-lowering agents. There is significant inter-patient variability in response to cardiovascular therapies, which contributes to risk for treatment failure or adverse drug effects.
Value in Health – Implementing new programs to support precision medicine in clinical settings is a complex endeavor. We describe challenges and potential solutions based on the Indiana GENomics Implementation: an Opportunity for the Underserved (INGenious) program at Eskenazi Health
Interventional Cardiology Clinics- This review describes genetic contributions to variable response to platelet P2Y12 inhibitors, guidelines for selecting antiplatelet therapy based on genotype, and examples of clinical implementation of genotype-guided antiplatelet therapy after PCI.
American Journal of Public Health – This issue of AJHP is a theme issue on precision medicine, focusing on the use of pharmacogenetics in the clinical setting. The articles included provide substantial insight on how and why pharmacogenetics might and can be implemented in the clinical setting.
American Journal of Health-System Pharmacy – The operational elements essential for establishing an inpatient pharmacogenetic service are reviewed, and the role of the pharmacist in the provision of genotype-guided drug therapy in pharmacogenetics programs at three institutions is highlighted.
American Journal of Pharmaceutical Education – Although clinical use of pharmacogenomic and genomic data to inform patient care decisions is increasing, it is not yet routine. Coverage of these concepts in health professions education, including pharmacy education, is lacking, and most practitioners feel inadequately prepared to apply these data in clinical practice.
The Journal of Molecular Diagnostics – Debates surrounding levels and types of evidence needed to properly evaluate the clinical value of molecular diagnostics are increasingly important because the growing body of knowledge, stemming from the increase of genomic medicine, provides many new opportunities for molecular testing to improve health care. We address the challenges in defining the clinical utility of molecular diagnostics for inherited diseases or cancer and provide assessment recommendations.
Future Cardiology – Clopidogrel is an ideal target for pharmacogenetic intervention for several reasons. First, there is a strong association between genotype, in this case CYP2C19 genotype, and clopidogrel effectiveness . Second, the consequences of reduced clopidogrel effectiveness, namely adverse cardiovascular events, can be life threatening and costly. Because of these reasons, an increasing number of institutions have implemented CYP2C19 genotyping to predict clopidogrel response into clinical practice.
Personalized Medicine – Family health history (FHH) information is well established as a basis for assessing a patient’s personal disease risk, but is underutilized for diagnosis and making medical recommendations. Epidemiological and genetic information have heightened the value of FHH to an individual’s health. This has motivated the development of new FHH collection tools and strategies for family members, but will require greater awareness and knowledge by both patients and practitioners.