PRACTICAL GENETICS
PHARMACOGENOMICS -
BAPTIST HEALTH PUTS PRECISION MEDICINE INTO ACTION WITH NEW PILOT PROJECT
AUTHOR John David Kolter , MD
Change , an inevitable fact of life , is generally an ideal in applied scientific fields as it represents the culmination of research and new knowledge . Lofty as this sounds , change is still hard . Physicians and health systems as a whole have been forced to embrace change in recent decades , but , more recently , the embrace of change has evolved to a proactive approach . One example of this locally is a pilot project at Baptist Health in the relatively new field of pharmacogenomics . In a drive to practice precision medicine , save money and avoid adverse drug effects in patients , pharmacogenomics has emerged as a tool to achieve these desired ends . While this is no small feat , pharmacogenomics is emerging within normal workflows at the clinical level . While the field of pharmcogenomics is still young , recognized clinically for a little over a decade , increased availability and recent reduction in costs of testing allows this previously research-based concept to change the real world practice of medicine .
Pharmacogenomics is the combination of pharmacology and genomics , the science of the human genome . The field looks primarily at the interaction of pharmacologic treatments in individual patients based on their particular genetic makeup . Pharmacogenetics , in contrast , looks at how variations in one single gene influence the response to a single drug . Examples of pharmacogenetics are already well established in current clinical practice , such as abacavir in HIV treatment and trastuzumab in breast cancer treatment . Pharmacogenomics , however , paints with a broader brush and has the ability to cross the lines of medication class as well as single gene interactions . While pharmacogenomics has felt somewhat far off from the day to day practice of medicine , many have seen signs of the emerging field in clinical practice for years now . Dr . Brett Oliver , Chief Medical Information Officer at Baptist Health and a practicing internist , notes , “ As a primary care physician , I have received pharmacogenomics reports here and there over the last 10 years . I would look at it once and potentially make adjustments based on findings . Then , the report would be filed away in the chart never to be read again , and certainly not known about when the patient is admitted or shows up in the ED .”
The experience of this author is similar noting , in our office , commercially available proprietary tests focused on genomics have been available for some time via third party vendors and at potentially considerable expense to the patient . These tests were well marketed , but rarely used clinically . Pharmacogenomics , though , is indeed inching closer to daily clinical practice with an expectation that in the near future , physicians may have access to a patient ’ s genomic data without specifically ordering it themselves .
Recognizing the paramount importance of proactively investing in tools to allow clinical translation of pharmacogenomic data ,
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