Research Article

Workforce readiness for pharmacogenomics and key elements for sustainment within the Veterans Health Administration

*Author for correspondence:

Division of General Internal Medicine, Precision Medicine Program, Department of Medicine, Duke University, Durham, NC 27708, USA

Durham VA Medical Center, Durham, NC 27705, USA

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Richelle Benevent

IBM Consulting, Washington DC, WA 20005, USA

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Nina R Sperber

Division of General Internal Medicine, Precision Medicine Program, Department of Medicine, Duke University, Durham, NC 27708, USA

Durham VA Medical Center, Durham, NC 27705, USA

Department of Population Health, Duke University, Durham, NC 27708, USA

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Jill S Bates

Durham VA Medical Center, Durham, NC 27705, USA

Department of Veterans Affairs, National Pharmacogenomics Program, Washington DC, WA 20420, USA

Division of Practice Advancement & Clinical Education, Eschelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA

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Daniel Villa

Titan Alpha, LLC, Chantilly, VA 20151, USA

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Dilhan Weeraratne

IBM Consulting, Washington DC, WA 20005, USA

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Timothy A Burrell

https://orcid.org/0000-0001-7973-7803

IBM Consulting, Washington DC, WA 20005, USA

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Deepak Voora

Division of General Internal Medicine, Precision Medicine Program, Department of Medicine, Duke University, Durham, NC 27708, USA

Durham VA Medical Center, Durham, NC 27705, USA

Department of Veterans Affairs, National Pharmacogenomics Program, Washington DC, WA 20420, USA

Department of Medicine, Division of Cardiology, Duke University, Durham, NC 27708, USA

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Published Online:5 Mar 2024https://doi.org/10.2217/pgs-2023-0193

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Abstract

Aim: Understanding barriers and facilitators to pharmacogenomics (PGx) implementation and how to structure a clinical program with the Veterans Health Administration (VA). Materials & methods: Healthcare provider (HCP) survey at 20 VA facilities assessing PGx knowledge/acceptance and qualitative interviews to understand how best to design and sustain a national program. Results: 186 (12% response rate) surveyed believed PGx informs drug efficacy (74.7%) and adverse events (71.0%). Low confidence in knowledge (43.0%) and ability to implement (35.4–43.5%). 23 (60.5% response rate) interviewees supported a nationally program to oversee VA education, consultation and IT resources. Prescribing HCPs should be directing local activities. Conclusion: HCPs recognize PGx value but are not prepared to implement. Healthcare systems should build system-wide programs for implementation education and support.

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Vol. 25, No. 3

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History

Received 9 October 2023

Accepted 14 February 2024

Published online 5 March 2024

Published in print February 2024

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Keywords

Author contributions

RR Wu made substantial contributions to design of work, developed the analytic plan and drafted and revised the manuscript. R Benevent made substantial contributions to design of work, completed the analysis and reviewed and edited the manuscript. NR Sperber made substantial contributions to design of work and the interpretation of the data, and reviewed and edited the manuscript. JS Bates made substantial contributions to design of work and the interpretation of the data, and reviewed and edited the manuscript. D Villa made substantial contributions to acquisition of the data and reviewed and edits the manuscript. D Weeraratne made substantial contributions to design of work, acquisition of and interpretation of the data, and reviewed and edited the manuscript. TA Burrell made substantial contributions to design of work, acquisition of and interpretation of the data and reviewed and edited the manuscript. D Voora made substantial contributions to design of work and the interpretation of the data, and reviewed and edited the manuscript. All authors gave final approval of the version of the manuscript to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Financial disclosure

This work was funded and supported by the Veterans Health Administration PHASER program. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Competing interests disclosure

RRW is employed by 23andMe. She is a co-founder and shareholder of MeTree&You. Neither organization supported her effort, contributed, or benefited in any way from the research contained in this manuscript. The remaining authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that this was determined to be a quality improvement project and thus institutional review board approval was not needed. They have followed the principles outlined in the Declaration of Helsinki for all human experimental investigations.

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