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      Addressing disparities in pharmacogenomics through rural and underserved workforce education

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          Abstract

          Introduction: While pharmacogenomic (PGx) testing is routine in urban healthcare institutions or academic health centers with access to existing expertise, uptake in medically-underserved areas is lagging. The primary objective of this workforce education program is to extend access to didactic, case-based and clinical PGx training for pharmacists serving rural Minnesota and populations experiencing health disparities in Minnesota.

          Methods: A PGx workforce training program funded through the Minnesota Department of Health was offered through the University of Minnesota College of Pharmacy (COP) to pharmacists working in rural and/or underserved areas in the state of Minnesota. Learning activities included a 16-week, asynchronous PGx didactic course covering PGx topics, a 15-min recorded presentation, an in-person PGx case-based workshop, and a live international PGx Conference hosted by the University of Minnesota COP and attendance at our PGx Extension of Community Health Outcomes (ECHO).

          Results: Twenty-nine pharmacists applied for the initial year of the program, with 12 (41%) being accepted. Four (33%) practiced in a hospital setting, four (33%) in retail pharmacy, two (17%) in managed care, and two (17%) in other areas. The majority had not implemented a PGx program as part of their practice, although nearly all responded definitely or probably yes when asked if they expected their organization to increase its use of PGx testing services over the next three years. All participants either strongly or somewhat agreed that this program helped them identify how and where to access clinical PGx guidelines and literature and improved their ability to read and interpret PGx test results. Eight participants (67%) strongly or somewhat agreed that they expected to increase the number of PGx consultations in their practice, while ten (83%) strongly or somewhat agreed they would be able to apply what they learned in this program to their practice in the next six months to a year.

          Discussion: This novel PGx training program focused exclusively on pharmacists in rural and/or underserved areas with a delivery method that could be accomplished conveniently and remotely. Although most participants’ organizations had yet to implement PGx testing routinely, most anticipated this to change in the next few years.

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          Precision medicine--personalized, problematic, and promising.

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            Pharmacogenomics

            Genomic Medicine, using DNA variation to individualize and improve human health, is the subject of this series of reviews. The idea that genetic variation can be used to individualize drug therapy – the topic addressed here – is often viewed as “low-hanging fruit” for Genomic Medicine. We review general mechanisms underlying variability in drug action, the role of genetic variation in mediating beneficial and adverse effects through variable drug concentrations (pharmacokinetics) and drug actions (pharmacodynamics), available data from clinical trials, and ongoing efforts to implement pharmacogenetics in clinical practice.
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              Health equity in the implementation of genomics and precision medicine: A public health imperative

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                Author and article information

                Contributors
                Journal
                Front Genet
                Front Genet
                Front. Genet.
                Frontiers in Genetics
                Frontiers Media S.A.
                1664-8021
                16 January 2023
                2022
                : 13
                : 1082985
                Affiliations
                [1] 1 Pharmacy Practice and Pharmaceutical Sciences , University of Minnesota College of Pharmacy , Duluth, MN, United States
                [2] 2 Experimental and Clinical Pharmacology , University of Minnesota College of Pharmacy , Minneapolis, MN, United States
                [3] 3 Pharmaceutical Care and Health Systems , University of Minnesota College of Pharmacy , Minneapolis, MN, United States
                [4] 4 Medicinal Chemistry , University of Minnesota College of Pharmacy , Minneapolis, MN, United States
                Author notes

                Edited by: Erica Woodahl, University of Montana, United States

                Reviewed by: Julio Duarte, University of Florida, United States

                Karen E. Brown, University of Montana, United States

                *Correspondence: Jacob T. Brown, jtbrown@ 123456d.umn.edu

                This article was submitted to Pharmacogenetics and Pharmacogenomics, a section of the journal Frontiers in Genetics

                Article
                1082985
                10.3389/fgene.2022.1082985
                9884975
                36726715
                3afd7933-9b46-4a52-84b4-c62d30418da5
                Copyright © 2023 Brown, McGonagle, Seifert, Speedie and Jacobson.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 28 October 2022
                : 28 December 2022
                Funding
                Funded by: Minnesota Department of Health , doi 10.13039/100004956;
                Award ID: 196015
                This work was supported through a grant provided by the Minnesota Department of Health through its Office of Rural Health and Primary Care. (Grant #196015).
                Categories
                Genetics
                Original Research

                Genetics
                pharmacogenomics,pharmacogenetics,rural,underserved,education
                Genetics
                pharmacogenomics, pharmacogenetics, rural, underserved, education

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