What Are the Barriers and Enablers to the Implementation of Pharmacogenetic Testing in Mental Health Care Settings?

JAMESON, Adam, FYLAN, Beth, BRISTOW, Greg C., SAGOO, Gurdeep S., DALTON, Caroline, CARDNO, Alastair, SOHAL, Jaspreet and MCLEAN, Samantha L. (2021). What Are the Barriers and Enablers to the Implementation of Pharmacogenetic Testing in Mental Health Care Settings? Frontiers in Genetics, 12.

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Official URL: https://www.frontiersin.org/articles/10.3389/fgene...
Open Access URL: https://www.frontiersin.org/articles/10.3389/fgene... (Published version)
Link to published version:: https://doi.org/10.3389/fgene.2021.740216
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    Abstract

    In psychiatry, the selection of antipsychotics and antidepressants is generally led by a trial-and-error approach. The prescribing of these medications is complicated by sub-optimal efficacy and high rates of adverse drug reactions (ADRs). These both contribute to poor levels of adherence. Pharmacogenetics (PGx) considers how genetic variation can influence an individual’s response to a drug. Pharmacogenetic testing is a tool that could aid clinicians when selecting psychotropic medications, as part of a more personalized approach to prescribing. This may improve the use of and adherence to these medications. Yet to date, the implementation of PGx in mental health environments in the United Kingdom has been slow. This review aims to identify the current barriers and enablers to the implementation of PGx in psychiatry and determine how this can be applied to the uptake of PGx by NHS mental health providers. A systematic searching strategy was developed, and searches were carried out on the PsychInfo, EmBase, and PubMed databases, yielding 11 appropriate papers. Common barriers to the implementation of PGx included cost, concerns over incorporation into current workflow and a lack of knowledge about PGx; whilst frequent enablers included optimism that PGx could lead to precision medicine, reduce ADRs and become a more routine part of psychiatric clinical care. The uptake of PGx in psychiatric care settings in the NHS should consider and overcome these barriers, while looking to capitalize on the enablers identified in this review.

    Item Type: Article
    Additional Information: ** From Frontiers via Jisc Publications Router ** Licence for this article: http://creativecommons.org/licenses/by/4.0/ **Journal IDs: eissn 1664-8021 **History: published_online 22-09-2021; accepted 30-08-2021; submitted 12-07-2021; collection 2021
    Uncontrolled Keywords: Genetics, pharmacogenomics, pharmacogenetics, pharmacogenetic testing, psychiatry, mental health
    Identification Number: https://doi.org/10.3389/fgene.2021.740216
    SWORD Depositor: Colin Knott
    Depositing User: Colin Knott
    Date Deposited: 06 Oct 2021 09:51
    Last Modified: 06 Oct 2021 10:00
    URI: http://shura.shu.ac.uk/id/eprint/29132

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