Feasibility of Pharmacogenetic Testing with Clinical Decision Support in Primary Healthcare in Singapore

The initial efforts to pilot implementation of pharmacogenomics to guide safe and effective drug dosing have largely focused on hospital-based systems with access to genetic-testing facilities and staff trained in genomics data analysis. To impact incidence of adverse drug responses on a national level, it is also vital to provide general practitioners with access to this technology. We therefore conducted a study to assess the feasibility of buccal sample collection by general practitioners at private practices in Singapore within a usual consultation, incorporating use of a pharmacogenomics-based medical-decision support system to guide subsequent drug dosing. All patients participating in the study were found to have at least one actionable variant. This is the first study in Singapore to demonstrate the feasibility of pharmacogenetic testing in primary care. The high prevalence of genetic variants underscores the potential use of pharmacogenetics in this setting.