Defining Core Functions and Forms for the Implementation of Pharmacogenomics Testing in Primary Care

Decomposition of the pharmacogenomic intervention into invariant core functions and locally adaptable forms

Pharmacogenomic testing remains sparsely integrated into primary care, although it constitutes a complex health intervention made of several interdependent components. The authors held an in-person workshop with early adopters from the Pharmacogenomics Global Research Network Implementation Working Group, followed by qualitative interviews with key opinion leaders, to identify the core functions and forms required for that implementation. Six core functions were agreed on by participants: patient identification, test ordering, laboratory testing, returning results, providing medication recommendations, and modifying pharmacotherapy; key opinion leaders added leadership engagement. Forms, meaning the concrete ways each function is carried out, varied considerably with local context and available resources. The authors argue for separating these two levels in order to balance fidelity to the model with adaptation to local settings.

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

Separating what must be preserved everywhere — the six functions — from what can adapt locally is probably the only way to roll out pharmacogenomics without diluting it, and this distinction was missing from the field. The paper remains a position paper arising from a workshop: neither the number of participants nor the qualitative analysis method appears in the abstract, and none of the six functions is assessed against a patient outcome. It is a useful organizational framework for setting up an implementation project, not a demonstration that it improves prescribing.

Analysis by Dr Thibaut Benquey