Exploring a Laboratory Model of Pharmacogenetics as Applied to Clinical Decision Making

Abstract

Objective: To evaluate a pilot of a laboratory model for relating pharmacogenetics to clinical decision making. Case Study: This pilot

was undertaken and evaluated to help determine if a pharmacogenetics laboratory should be included in the core Doctor of

Pharmacy curriculum. The placement of the laboratory exercise in the curriculum was determined by identifying the point in the

curriculum where the students had been introduced to the chemistry of deoxyribonucleic acid (DNA) as well as instructed on the

chemistry of genetic variation. The laboratory included cytochrome P450 2C19 genotyping relative to the *2 variant. Twenty-four

students served as the pilot group. Students provided buccal swabs as the source of DNA. Students stabilized the samples and were

then provided instructions related to sample preparation, polymerase chain reaction, and gel electrophoresis. The results were

reported as images of gels. Students used a reference gel image to compare their results to. Students then applied a dosing algorithm

to make a “clinical decision” relative to clopidogrel use. Students were offered a post laboratory survey regarding attitudes toward

the laboratory. Twenty-four students completed the laboratory with genotyping results being provided for 22 students (91.7%).

Sixteen students were wild-type (*1/*1), while six students were heterozygous (*1/*2). Twenty-three students (96%) completed the

post laboratory survey. All 23 agreed (6, 26.1%) or strongly agreed (17, 73.9%) that the laboratory “had relevance and value in the

pharmacy curriculum”. Conclusion: The post pilot study survey exploring a laboratory model for pharmacogenetics related to clinical

decision making indicated that such a laboratory would be viewed positively by students. This model may be adopted by colleges to

expand pharmacogenetics education.