Barriers and facilitators to the implementation of pharmacogenomic testing for antidepressants use in primary care: a systematic review using the consolidated framework for implementation research.

Organisational determinants of pharmacogenomic testing implementation, analysed with the CFIR framework.

This systematic review searched MEDLINE, EMBASE, Scopus, CINAHL, APA PsycINFO and Web of Science to March 2025 to identify barriers and facilitators to pharmacogenomics-guided antidepressant prescribing in primary care. From 979 records screened by two independent reviewers, thirteen qualitative or mixed-methods studies were retained, involving clinicians, administrators, policymakers and patients, analysed with the CFIR framework. Barriers were limited perceived evidence, cost and reimbursement uncertainty, intervention complexity, workflow disruption and low clinician confidence. Facilitators were perceived relative advantage, pharmacist-led support, interprofessional collaboration, reimbursement, clinical integration, adaptable delivery models and training.

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

A methodologically clean systematic review — six databases, dual screening, a predefined analytical framework — but one that produces no clinical data: it describes what stakeholders think, not what works. Its value lies elsewhere, in the finding that the leading barrier remains perceived evidence, which places the burden on clinical trials rather than on care organisation alone. Worth remembering for any project deploying pharmacogenomics in general practice: without a reimbursement pathway and pharmacist support, implementation fails whatever panel is offered.

Analysis by Dr Thibaut Benquey