Erik Hefti, PharmD, MS, PhD
Erik Hefti holds a PharmD as well as a Master's and PhD degrees in pharmaceutical science from the University at Buffalo. His research focuses on pediatric pharmacogenomic factors impacting cardiovascular toxicity following cancer chemotherapy and genetic testing utilization to improve healthcare outcomes. His clinical focus involves optimizing pharmacotherapy in patients with genetic disorders. He is the program director and assistant professor of pharmaceutical sciences at Harrisburg University in Harrisburg, PA.
Currently, there are multiple applications of personalized medicine in clinical practice, including assisting in medication selection. Unfortunately, a personalized medicine knowledge gap currently exists between many healthcare providers in the United States, and around the globe.1-3
Personalized medicine is a relatively recent development in the healthcare sphere. Incorporating genomics into clinical decision making has only been feasible with the advent of improved technologies allowing cost-effective genomic analysis. Genomic diagnostic and decision-making tools are being developed at a higher rate now than ever before. Unfortunately, didactic coursework in healthcare curricula that prepares healthcare professionals to utilize personalized medicine has been slow to catch up. This has left many practicing healthcare professionals in the workforce without formal training in personalized medicine, which may be hampering adoption of personalized medicine.
One obvious solution to addressing this personalized medicine knowledge gap in healthcare professionals involves incorporating more robust didactic, and experiential education into the curriculums of medical, nursing, pharmacy, and related programs. Formal classes in pharmacogenomics have been widely implemented in many pharmacy programs in the United States; however, there are still challenges that face expanding classroom education.4
It may be difficult to find room in the curriculums of many programs that train healthcare professionals. Furthermore, personalized medicine is a large, somewhat diffuse field of study that encompasses diverse disciplines. It can be difficult to compress the many aspects of personalized medicine into a single course that adequately trains healthcare professionals to confidently utilize these tools in practice. Another problem with simply expanding didactic training is that it does not address the healthcare professionals currently in the workforce. These individuals will not benefit from expanding formal training in personalized medicine. Furthermore, these professionals can often make the best use of precision medicine, given their experience and clinical knowledge.
So, how can we address this knowledge gap? Some possibilities include a combination of pre- and post-graduate education in addition to employing a multidisciplinary approach to patient care. It is critical that personalized medicine topics be presented in healthcare curricula. While there may not be time to delve into all topics comprehensively in the classroom, foundational instruction in personalized medicine will allow for more efficient learning in a practice setting, as needed. More post-graduate continuing education programs could be developed for healthcare professionals in disciplines that currently utilize personalized medicine. Another potential approach would be developing programs designed for working/practicing professionals to become more formally educated in personalized medicine. These include certificate, and degree programs that can be taken in a distance-learning format.
For some clinicians currently practicing, robust clinical decision support software that incorporates personalized medicine may also assist in filling the knowledge gap by quickly providing evidence-based recommendations with respect to incorporating personalized medicine into care.5,6 Also, incorporating healthcare professionals with more developed knowledge in a specific aspect of personalized medicine (such as a pharmacist trained in pharmacogenomics) into a multidisciplinary clinical team can further leverage the strengths of each member to best treat the patient.1 Discussing the evidence, and approaches within a multidisciplinary team can build a better knowledge base of participating members, and ultimately improve patient care.
The education gap in personalized medicine may be a potential barrier to broad implementation currently; however, this gap may shrink with more robust developments in the field combined with more robust pre- and post-graduate education opportunities for healthcare professionals.
- Haiech J, Kilhoffer M-C. Personalized medicine and education: the challenge. Croatian medical journal 2012; 53(4): 298-300.
- Taber KAJ, Dickinson BD. Pharmacogenomic knowledge gaps and educational resource needs among physicians in selected specialties. Pharmacogenomics and personalized medicine 2014; 7: 145.
- Hinderer M, Boeker M, Wagner SA, et al. The experience of physicians in pharmacogenomic clinical decision support within eight German university hospitals. Pharmacogenomics 2017; 18(8): 773-85.
- Rao US, Mayhew SL, Rao PS. Strategies for implementation of an effective pharmacogenomics program in pharmacy education. Pharmacogenomics 2015; 16(8): 905-11.
- Hinderer M, Boeker M, Wagner SA, et al. Integrating clinical decision support systems for pharmacogenomic testing into clinical routine-a scoping review of designs of user-system interactions in recent system development. BMC medical informatics and decision making 2017; 17(1): 81.
- Hinderer M, Boerries M, Boeker M, et al. Implementing Pharmacogenomic Clinical Decision Support into German Hospitals. Studies in health technology and informatics 2018; 247: 870-4.