Pharmacogenomic (PGx) Testing for Consultant Pharmacists [2018]


What is pharmacogenomic testing and how
can a pharmacist use it to improve patient outcomes? Find out next. Hi I’m Blair Thielemier and I work with
pharmacists who want to build and grow their advanced clinical services. Today I
want to talk to you about pharmacogenomic testing. Pharmacogenomic testing is identifying genes that may affect enzymes
responsible for hepatic metabolism of certain medications. So back in
pharmacology and kinetics you may remember learning about the cytochrome
P450 enzymes. Those enzymes are some of the ones that we look at in a
pharmacogenomic test. In addition, we also look at HLA-A and B, which the presence
of those alleles may indicate hypersensitivity to carbamazepine or
phenytoin. We also look at OPRM1, which, for my genotype specifically,
shows a decreased sensitivity to analgesics, but it could go either way. We
also look at the COMT gene which indicates whether or not the body is
producing enzymes that can clear dopamine and norepinephrine from the
synapse. We also look at SLCO1B1, which tells us if the patient is more at
risk for statin induced myopathy. And for thrombosis risk, we can look at genes
that code for Factors two and five. As far as CPT codes there are no CPT codes
that code specifically for pharmacogenomic testing. The patient can
be referred to the pharmacist or to the physician for pharmacogenomic testing
based on the medications that they’re on and based on their diagnosis. Some
impactful activities for a pharmacist wanting to offer pharmacogenomic testing
either in their community pharmacy setting or in a physician’s office
setting is: 1.) In collaboration with the practice, to create a formulary
of drugs that would benefit from a pharmacogenomic test. 2.) Use
pharmacogenomic testing in practices to offer annual wellness visits or chronic
care management services so you could have an ongoing impact on that patients
care and continue to use the test throughout
the life of the patient. 3.) If you’re seeing patients and giving
them the results of their pharmacogenomic test in a physician’s
office setting under collaborative practice, you can bill for the pharmacist
interpretation using the incident to billing codes. To refer back to the
incident to billing criteria, check out our last video on incident to billing. If this video was helpful to you, please consider subscribing to our YouTube
channel and sharing it with a colleague. And if you are interested in learning
more about advanced clinical pharmacy services check out our website