Clinical Implementation of Pre-Emptive Pharmacogenomic Testing as a Precision Medicine Tool in Routine Clinical Practice in Singapore (PGx)

One drug doesn’t fit all – this is the premise of pharmacogenomics, a study of how genomic variations affect drug response. Despite emerging evidence of benefit from the literature and the availability of clinical guidelines, adoption of pharmacogenomics into routine clinical care has been slow. Barriers in implementation include lack of access to testing, informatics infrastructure, knowledge and awareness. The National University Health System (NUHS) has been working on facilitating the incorporation of pharmacogenomics into daily clinical practice through the novel approach of pre-emptive testing. This approach involves testing a panel of genes ahead of time, storing genomic data within electronic health records and firing prompts with clinical decision support at the point of care. The presentation aims to discuss the journey of clinical implementation of pre-emptive pharmacogenomics at NUHS, the spread and scale of the initiative, as well as caveats to the use of pharmacogenomics in daily clinical practice.