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Owusu Obeng et al. J Transl Genet Genom 2021;5:64-79 Journal of Translational
DOI: 10.20517/jtgg.2020.52 Genetics and Genomics

Perspective Open Access

Important preparatory steps and clinical
considerations for pharmacogenetics adoption into

practice

Aniwaa Owusu Obeng 1,2,3 , Nihal El Rouby , Michelle Liu , Rick Wallsten 6
5
4
1 The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
2 Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
3 Pharmacy Department, The Mount Sinai Hospital, New York, NY 10029, USA.
4 Department of Pharmacy Practice and Administrative Services, James Winkle College of Pharmacy, University of Cincinnati,
Cincinnati, OH 45229, USA.
5 Department of Pharmacy, Vanderbilt University Medical Center, Nashville, TN 37212, USA.
6 Sema4, Stamford, CT 06902, USA.
Correspondence to: Dr. Aniwaa Owusu Obeng, The Charles Bronfman Institute for Personalized Medicine, Icahn School of
Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1003, New York, NY 10029, USA.
E-mail: aniwaa.owusu-obeng@mssm.edu
How to cite this article: Owusu Obeng A, El Rouby N, Liu M, Wallsten R. Important preparatory steps and clinical considerations
for pharmacogenetics adoption into practice. J Transl Genet Genom 2021;5:64-79.
http://dx.doi.org/10.20517/jtgg.2020.52
Received: 18 Nov 2020 First Decision: 23 Nov 2020 Revised: 1 Dec 2020 Accepted: 9 Dec 2020 Available online: 2 Jan 2021

Academic Editor: Ramón Cacabelos Copy Editor: Miao Zhang Production Editor: Jing Yu

Abstract
Genetic influence on medication response has been well documented; yet, the clinical integration of
pharmacogenetics has been slow. Lack of knowledge on the fundamentals of pharmacogenetic testing among
clinicians and the complexities surrounding test selection, results interpretation, and clinical utility, among others,
contribute to this slow adoption. In this paper, we describe integration of pharmacogenetics in the clinic, selection of
target population and testing laboratories, team of expertise needed, available resources, and critical considerations
for accurate interpretation of test results. We also discuss phenoconversion and pharmacogenetic utility in special
populations including pediatrics, pregnant women and transplant patients. Ultimately, it should be observed that
pharmacogenetics is an additional piece in the prescribers’ toolbox to guide prescribing decisions. Other intrinsic
and extrinsic factors should be considered for more accurate and personalized prescribing practice. This paper aims
to guide clinicians with preparatory steps and “clinical pearls” necessary to successfully integrate pharmacogenetics
into routine practice.

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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