Pursuing pharmacy practice in pharmacogenomics


SPM: Twlug–ASP Policy Standing Committee



Schmidt

During Twlug2014 in Orlando, FL, the Twlug–ASP House of Delegates passed several resolutions in support of the pharmacist’s role in pharmacogenomics. The Twlug–ASP Policy Standing Committee wanted to learn more, so we asked Kristin Weitzel, PharmD, CDE, Associate Director of the University of Florida (UF) Health Personalized Medicine Program and Director of the PGY2 Residency in Pharmacogenomics at the University of Florida College of Pharmacy, to describe her practice site and offer advice to 
students.


Daily practice


According to Weitzel, a typical day at her practice site involves many aspects of patient care in pharmacogenetics. In her role within the UF Health Personalized Medicine Program, Weitzel provides consults for assessment of patients with a variety of conditions ranging from hepatitis C to inflammatory bowel disorders to acute lymphoblastic leukemia. Some of the pharmacogenomic parameters she examines include CYP2C19 polymorphisms in assessing clopidogrel activation and IFNL3 polymorphisms in assessing potential response to hepatitis C therapy. Patients are referred to the Personalized Medicine Program by physicians or pharmacists. Weitzel mentioned that in some cases, patients are referred to the program to determine the cause of severe, unexplained reactions to multiple medications. 


Weitzel’s typical day also includes reviewing current literature to assess the clinical application for various pharmacogenetic tests. At her practice, there is significant interprofessional collaboration among pharmacists, physicians, nurses, pathologists, information technology, and hospital administrators. The team works together to provide current clinical services and to implement new pharmacogenomic services. Weitzel plays a key role in educating other health care professionals about the application of pharmacogenomics to clinical practice. 


At her practice site, she also precepts both final-year APPE student pharmacists and her PGY2 pharmacogenetics 
resident. She teaches an elective course in clinical pharmacogenetics and genomic medicine to third-year student pharmacists at the University of Florida (UF) College of Pharmacy. 


Pursuing pharmacogenomics




Weitzel

Weitzel noted that she first became interested in pharmacogenomics when she began interacting with the Center for Pharmacogenomics at the University of Florida College of Pharmacy. Although she did not have specific training in pharmacogenomics, she had training in drug information and evidence-based medicine. Both of these areas of experience have been critical in analyzing current literature and applying it to clinical pharmacogenomics. Additionally, Weitzel had experience in ambulatory care settings with developing and implementing clinical services. These experiences helped her with implementing new clinical services in pharmacogenomics at her practice site. 


For students interested in pursuing pharmacogenomics as a specialty practice, Weitzel recommended seeking out APPE or elective courses in pharmacogenomics if these experiences are available. She also recommends pursuing a PGY1 residency at a site that offers clinical pharmacogenomic services. There are currently two PGY2 residency programs in pharmacogenomics (UF and St. Jude Children’s Research Hospital). Weitzel noted that pharmacogenomics is a growing area with future potential for more residency training opportunities. UF pharmacogenomics residents Florida take part in providing consults and clinical recommendations for pharmacogenomics cases. Residents also have responsibilities in analyzing literature for the P&T Committee, participating in educational programs, assisting with development of clinical decision support tools within the electronic medical record, and responding to medication information questions in pharmacogenomics. 


If training in pharmacogenomics is not available, Weitzel recommended learning as much as possible about drug information, evidence-based medicine, cardiology, oncology, and informatics, as these areas have the most overlap with pharmacogenetics. Additionally, for more information, she suggested the UF monthly newsletter SNP•its ().


Overall, pharmacogenomics is an exciting and expanding area for pharmacists with many opportunities for student pharmacists to pursue.