GP practices will be using pharmacogenetic testing to guide prescribing decisions in patients taking statins, antidepressants and proton pump inhibitors, in a pilot due to begin early next year.
As first reported in The Pharmaceutical Journal, five GP practices in the North West of England will be looking at the feasibility of genetic testing before prescribing, ahead of a wider roll out over the next one to three years.
The NHS-funded pilot is part of the Progress Programme, led by the University of Manchester, aiming to investigate how genetic testing can help spot when patients may not respond to a drug, may need a different dose, or may be at risk of adverse effects because of differences in how they metabolise medicines.
Work is currently being done to select which commercially available test will be used in the pilot and to develop the IT systems so the results can be included in the patient record in a useful way, the research team said.
Three practices in Greater Manchester, one in Liverpool and one in Cheshire will be involved in the pilot, which is part of wider plans to introduce pharmacogenetic testing more routinely in the NHS. Work is also happening in Scotland and Wales to investigate how testing can be best used in routine care.
An NHS England five-year plan on genomic medicine published this month said over the next three years it will review the evidence for ‘real-time’ decisions informed by pharmacogenomics to become ‘part of routine clinical care’.
Professor William Newman, professor of translational genomic medicine at the University of Manchester, this was not about proving the case for pharmacogenomic testing, which had been done in other studies but to look at the practicalities of doing this in the NHS.
He told The PJ: ‘This is an implementation study to see if we can get a sample from a patient to the lab and back again, and [to see if] that information is actioned and is acceptable to the patient and to the GP.
‘We need to know what the challenges are and how to scale it. Ultimately, we would be looking and hoping that we will be able to do this across large populations.’
Should the pilot prove successful, more small-scale roll out is expected in the other six NHS Genomic Medicine Alliance regions, with other early adopter GP practices expected to trial the technology.
GP pharmacists will play a key role in implementing the testing which initially will only be done in patients getting new prescriptions or when switching a medication.
RCGP chair Professor Martin Marshall said: ‘Genomics already have an important role in medicine and patient care, and this is likely to increase in the future. It’s important that any genomic intervention is implemented safely and responsibly.
‘We look forward to seeing the results of this research and a full evaluation of the pilot programme to see if and how it should be rolled out more widely, in the best interests of patient care.’
An NHS spokesperson said: ‘The NHS is piloting offering pharmacogenomic testing in a small number of GP practices and will review the evidence to inform potential wider implementation.’
READERS' COMMENTS [3]
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I don’t quite understand what and how outcomes would be measured to determine ‘success’. Patients either included or excluded from a treatment on the basis of the test, but over what period and how many patients to determine reductions in events and mortality according to chosen treatment? It’d have to have a massive difference effect to warrant whole-population screening (eg for statins or not).
Reminiscent of CRP testing before prescribing antibiotics. What happened to that?
@Nick
If you follow the link you will see that they’re only trying to establish feasibility (whether it can be done), not benefit (whether it should be done). So they aren’t collecting the sort of outcome data you rightly wish to see… which is OK, as long as this work then isn’t wrongly presented as evidence that testing is beneficial.