Scientific Poster Session III - Clinical Pharmacy Forum

Clinical Pharmacy Forum
  Monday, November 13, 2023
  01:00 PM–02:30 PM

Abstract

Service or Program:

St. Elizabeth Healthcare, based in Northern Kentucky, established a clinical pharmacogenomics (PGx) program in 2019 to enable PGx testing for patients and providers systemwide. The program was launched by a part-time PGx pharmacist, who initially focused implementation efforts in oncology.

Justification/Documentation:

Our decentralized model uses extensive chart review for consults. Providers place the PGx test order (a 27-gene panel) and PGx pharmacists review results, making recommendations for the initial indication and any ensuant findings. For example, a patient receiving testing to guide chemotherapy decisions may also receive recommendations for antidepressant or antiplatelet therapy. Advantages of this model include holistic patient care and greater provider exposure to PGx applications. Clinical PGx service utilization has expanded markedly in the past 5 years from 3 patients tested in 2018, 767 in 2022, and over 2300 cumulatively as of May 2023.

Adaptability:

Initially launched in oncology, our comprehensive approach to PGx implementation allowed for expansion into other clinical areas, particularly primary care. Another full-time PGx pharmacist joined the program in 2022 and focused efforts around five key initiatives: patient/provider education, electronic clinical decision support (eCDS), in-house assay development, policies/procedures, and translational research designed to accelerate implementation efforts. Key elements of success include our comprehensive implementation approach, robust eCDS, and strategic use of quality improvement initiatives with key external partners (e.g., test manufacturers, third-party payors).

Significance:

In our institution, clinical pharmacists are recognized as the “owners” of PGx testing and information, and we are in the process of moving to a model that empowers clinical pharmacists across the system to take ownership of PGx results relevant to their specialty. PGx testing has become standard of care prior to any prescribing of capecitabine or fluorouracil, and we are in the process of establishing standards for pre-emptive testing for behavioral health and cardiology medications.

Presenting Author

Josiah Allen PharmD
St. Elizabeth Healthcare

Authors

Jaime Grund MS, CGC
St. Elizabeth Healthcare

Grace Miller BS
St. Elizabeth Healthcare

Nihal El Rouby PharmD, PhD
University of Cincinnati

Andrea Schumann PharmD
St. Elizabeth Healthcare