Personalized medicine in community practice

MAY 2016 – Researchers for the Pharmacists as Personalized Medicine Experts (PRIME) pilot project are aiming to prove that pharmacists in a community practice setting are well positioned to play a key role in the emerging field of personalized medicine.

Supported by a $50,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund, the project involves specially trained PRIME pharmacists working with patients and their prescribers to find out if genetics can help determine the best medication options. The focus for this pilot is on mental health, but the long-term goal is to be able to adapt the model in the community setting for other disease areas.

Phase one of the project, completed in January, involved training 25 pharmacists from across Ontario to become personalized medicine experts in their communities.  “When we put the call out for interested pharmacists, we got 140 responding within the first 48 hours,” says pharmacist Lisa McCarthy, who is leading the project with co-investigator/pharmacist Beth Sproule. “We really didn’t expect that much interest.” Coming from a range of backgrounds and clinical settings, the pharmacists underwent eight hours of initial online learning and two days of in-person workshops. That was followed up by another four weeks of online study cases.

In phase two, 22 pharmacists are going on to recruit patients whom they’ve determined will benefit from genetic testing. The recruitment process will run until December 2016, and so far 10 participating pharmacists have referred some 40 patients. “This is what we wanted to learn from pharmacists: if we build it, will they come?” asks McCarthy, who is an Assistant Professor at the Leslie Dan Faculty of Pharmacy. “We will be following up with the rest of participants to determine what some of their barriers might be.”

Ultimately, pharmacists should promote genetic testing only if it makes sense clinically. “These tests are expensive and we’ve really tried to encourage pharmacists to use them only when they think genomics will add to their clinical assessment,” says McCarthy.

In related news, 33 pharmacies in B.C. also participated in a recent pilot project exploring personalized medicine in the community setting. Funded by the British Columbia Pharmacy Association and Genome British Columbia, the first phase of the program, which wrapped up at the end of 2015, focused on developing operating procedures for the collection of patient saliva samples, to process and sequence DNA. In phase two, researchers will do a retrospective analysis of DNA information to determine how genetics may have changed the drug dosages prescribed to patients.