Improving acceptance of pharmacogenetic testing in patient care

Bank, P.C.D. (2018)

Doctoral Thesis

The aim of this thesis is to investigate the adoption of PGx and the integration of genotype guided dosing in the workflow of physicians and pharmacists in primary care. This thesis is divided into five parts. The first part provides an overview of answers to frequently asked questions by clinicians related to the implementation of PGx. The second part of this covers investigates whether genotype guided dosing in primary care is feasible in a pilot study
where 200 patients with an incident prescription for a subset of 10 drugs and historical use are genotyped in a panel based approach for 8 pharmacogenes and received genotype guided dosing based on recommendations of the DPWG guidelines and covers an assessment of the clinical impact of PGx in primary care in the Netherlands is provided to predict how many patients that start with a drug currently described in the guidelines of the DPWG require an optimization of therapy. Part III covers the harmonization of PGx-test interpretation and therapeutic recommendations. Part IV investigates the knowledge, experience and attitudes towards PGx among (future) healthcare professionals. The thesis is concluded with a general discussion.

• Pharmacogenetics
• Pharmacogenomics
• Primary care
• Clinical-decision-support
• Pharmacists
• Implementation
• Genotyping Drug-efficacy
• Drug-safety

• All authors: Bank, P.C.D.
• Supervisor: Guchelaar, H.J.
• Co-supervisor: Swen, J.J.
• Committee: Gussekloo, J.; Schaik, R.H.N. van; Wilffert, B.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden Uiversity Medical Center (LUMC), Leiden University
• Date: 2018-11-14
• ISBN (print): 9789492026156