Implementing clinical pharmacogenomics in the classroom: student pharmacist impressions of an educational intervention including personal genotyping

Pharmacogenomics provides a personalized approach to pharmacotherapy by using genetic information to guide drug dosing and selection; however, pharmacogenomic testing has not been fully implemented in clinical practice. A lack of pharmacogenomic-focused coursework in pharmacy education may be contributing to its low adoption into patient care. With extensive pharmacotherapy training and accessibility to patients, pharmacists are ideally equipped to drive clinical pharmacogenomics. This study aims to assess an innovative pharmacogenomic teaching method and elucidate its impact on students' perceptions regarding pharmacogenomics. Student pharmacists (N=222) participated in a 15-week educational intervention including pharmacogenomic presentation materials, patient case scenarios, and personal genotyping with 23andMe. Students completed a pre- and post- intervention survey to evaluate their attitudes and self-efficacy towards clinical pharmacogenomics. Responses were analyzed with McNemar's test and the Wilcoxon signed-rank test. In the post-survey, 36% of students in the paired subset agreed they would recommend personal genotyping for a patient compared to 19% pre-intervention (p=0.0032). Students were significantly more confident in applying pharmacogenomics to manage patients’ medications post- intervention, and more students believed that personal genomics will likely play an important role in their future career (p=0.0072). An educational intervention improved student pharmacists' attitudes and confidence regarding pharmacogenomics in the clinical setting.Doctor of Pharmac

CRT-100.12 Risk of Bleeding Among Cangrelor-Treated Patients Administered Upstream P2Y12 Inhibitor Therapy

Introduction: Little is known about the use of cangrelor in patients with MI who are treated with an oral P2Y12 inhibitor upstream prior to cardiac catheterization. Methods: CAMEO (Cangrelor in Acute MI: Effectiveness and Outcomes) is a 12-hospital observational registry studying platelet inhibition for MI patients undergoing cardiac cath. Upstream oral P2Y12 inhibition was defined as receipt of an oral P2Y12 inhibitor within 24 hours prior to hospitalization or in-hospital prior to cath. Among cangrelor-treated patients, we compared bleeding after cangrelor use through 7 days post-discharge between patients with and w/o upstream oral P2Y12 inhibitor exposure using logistic regression. We examined rates of bleeding among patients with a shorter (\u3c1 hour) vs. longer (1-3 hours or \u3e3 hours) duration between the last oral dose and cangrelor start. Results: Among 1,775 cangrelor-treated MI patients, 433 (24.4%) had upstream oral P2Y12 inhibitor treatment prior to cath. Of these, 165 patients (38%) started cangrelor within 1 hour, 109 (25%) between 1-3 hours, and 134 (31%) \u3e 3 hours after the in-hospital oral P2Y12 inhibitor dose. Cangrelor-treated patients who received upstream treatment were more likely to have a history of prior PCI, MI, PAD, and diabetes and to be clopidogrel-treated (all p\u3c0.01) compared w/o upstream treatment. There was no significant difference in risk of bleeding among cangrelor-treated patients with and w/o upstream oral P2Y12 inhibitor exposure (Table). While bleeding events were higher in patients with longer delays to cangrelor initiation, bleeding risk was not significant after adjustment (Table). Conclusions: Bleeding risk was not observed to be higher in cangrelor-treated patients after upstream oral P2Y12 inhibitor exposure compared with patients treated with cangrelor w/o upstream oral P2Y12 inhibitor exposure

Implementing Clinical Pharmacogenomics in the Classroom: Student Pharmacist Impressions of an Educational Intervention Including Personal Genotyping

Pharmacogenomics provides a personalized approach to pharmacotherapy by using genetic information to guide drug dosing and selection. However, partly due to lack of education, pharmacogenomic testing has not been fully implemented in clinical practice. With pharmacotherapy training and patient accessibility, pharmacists are ideally suited to apply pharmacogenomics to patient care. Student pharmacists (n = 222) participated in an educational intervention that included voluntary personal genotyping using 23andMe. Of these, 31% of students completed both pre- and post-educational interventions to evaluate their attitudes and confidence towards the use of pharmacogenomics data in clinical decision making, and 55% of this paired subset obtained personal genotyping. McNemar’s test and the Wilcoxon signed-rank test were used to analyze responses. Following the educational intervention, students regardless of genotyping were more likely to recommend personal genotyping (36% post-educational intervention versus 19% pre-educational intervention, p = 0.0032), more confident in using pharmacogenomics in the management of drug therapy (51% post-educational intervention versus 29% pre-educational intervention, p = 0.0045), and more likely to believe that personalized genomics would have an important role in their future pharmacy career (90% post-educational intervention versus 51% pre-educational intervention, p = 0.0072) compared to before receiving the educational intervention. This educational intervention positively influenced students’ attitudes and confidence regarding pharmacogenomics in the clinical setting. Future studies will examine the use of next-generation sequencing assays that selectively examine pharmacogenes in the education of student pharmacists