Pharmacogenetics and pharmacogenomics instruction in schools of pharmacy in the USA: is it adequate?

The provision of pharmaceutical care has been incorporated into the mission statements of virtually every pharmaceutical organization in the USA. It is defined as ‘the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life’ [1]. As such, the evolving fields of pharmacogenetics and pharmacogenomics complement the mission of pharmaceutical care by helping pharmacists to optimally individualize the shared responsibility of drug therapy with their patients [2]. The significant anticipated opportunities and challenges that pharmacogenetics/pharmacogenomics will bring to healthcare was the catalyst for an Academic Affairs Committee of the American Association of Colleges of Pharmacy (AACP) report in 2002 [3]. The committee reported the potential impact that pharmacogenetics/pharmacogenomics might have on the future roles of pharmacists [3]. In addition, the committee reported how pharmacy education might respond to this evolving knowledge base, in order to meet the needs of the profession and society. Guided by the National Coalition for Health Professional Education (NCHPEG) recommendations regarding health professional core competencies in genetics, the committee identified educational strategies and curricular outcomes, and addressed faculty development and resource implementation issues [3,4]. The AACP Academic Affairs Committee reported that the opportunities presented by pharmacogenetics and pharmacogenomics are significant, by stating: “the process will be to collect a single blood sample from each patient, submit an aliquot of the sample to a reference laboratory for analysis of a panel of genotypes, and test for those established to be important determinants of drug disposition and effects. The results of this one panel of tests would be electronically deposited into a secure database, into and out of which data can be accessed only with the patient’s authorization” [3]. Pharmacogenetics/pharmacogenomics present tremendous opportunities for pharmacists because of their potential to result in a true patient-specific customization of drug therapy that will optimize the provision of pharmaceutical care. The committee concluded that most disciplines in pharmacy education will be affected by pharmacogenetics/pharmacogenomics, and faculties will require requisite skills and knowledge in order to provide the latest research information to students regarding optimal applications and treatment choices [3]. They identified three salient domains, and several skills and competencies within each, in which pharmacists should be proficient. The domains included: the genetic basis of disease, drug discovery and disposition, ethical applications, and social and economic implications.