To deliver a
personalised medicine in the community, two potential models can be suggested:
GP testing and pharmacy testing. In the first model, GP testing, during the
diagnostic stage GP do the genetic tests. These genetic tests are carrying in
the same way as temperature monitoring. Then, GP makes a therapeutic decision
based on the results of these genetic test. Then, community pharmacist needs to
have enough knowledge and information to clinically check and dispense the
genetically informed prescription. In this method, in addition to checking for
normal drug-drug interaction, the pharmacist also check for with gene-drug
interactions as a part of clinical checking.
One of the challenges for implementation of this model is lack of
availability of the technology that supplies accurate genetic test results
quickly in order that genetic testing can be carried out during a patient’s
the second model pharmacist carrying out the genetic testing. After issuing the
prescription to the GP, the genetic test will perform by the pharmacists in the
community pharmacy and the results of the tests will combine with all other
patient’s background and genetic information and as a result, right medicine,
with the right dose will be given to the right patient at the right time.
However, to obtain this goal, pharmacists need to learn how to analyse genetic
information like SNPs (single-nucleotide polymorphisms) and relate them to the
patient’s abilities to metabolize, transport, or respond to certain drugs. This
approach will result to tailor dosing regimen from standard to individual ones.
And finally, by minimising the risk of side effects, patients will receive the
safest and most effective therapy
model also faces some challenges. First of all, how the pharmacist with the
heavy load of works, can do genetic testing for all of their patients. Then,
the technology, which enables the pharmacist to use swabs and get the results
within the few minutes need to develop. And lastly, pharmacist need to educate
how to have a proper communication with their patients to explain everything
clearly and be able to answer all of their patient’s questions 12.