PERSONALIZED MEDICINE AND THE EXPANDING ROLE OF CLINICAL PHARMACISTS: FROM SCIENTIFIC FOUNDATIONS TO REAL WORLD IMPLEMENTATION

Personalized medicine, or precision medicine, is a concept that represents a major change in the direction of medicine. It means that instead of treating patients according to their population, medication is being prescribed based on individual patient characteristics which might include genetic, phenotypic, clinical, and environmental factors. Fast progress in biomarker discovery, pharmacogenomics, therapeutic drug monitoring, and clinical informatics over the last 20 years has guaranteed personalized medicine to move from just a conceptual framework to an actionable approach over many therapeutic areas. Because of their educational background, clinical pharmacists are the ones who are most qualified to apply personalized medicine in day-to-day practice; they possess skills that relate to pharmacogenomics, pharmacodynamics, medication safety, and interdisciplinary care coordination. In spite of this, the uptake of pharmacist-enabled personalized medicine services remains irregular in different healthcare systems sharing a similar situation. Shortages in professional training, incomplete clinical infrastructure, fewer reimbursement options, different regulations, and unequal access to decision-support technologies are some of the reasons that still hinder broad implementation. This article takes a critical view of the scientific bases on which personalized medicine stands and at the same time, takes a close look at the more important part that clinical pharmacists have in turning precision tools into everyday care. The main activities of pharmacists such as choosing and interpreting pharmacogenomic tests, dosing guided by genotype, monitoring drug therapy, preventing adverse drug reactions, educating patients and healthcare providers, and managing expensive targeted therapies are discussed in the context of the major therapeutic domains. Moreover, the available evidence about clinical outcomes, economic impact, and patient-centered advantages resulting from the participation of pharmacists is summed up together with the ongoing difficulties in implementing it. Besides, tactical methods that will empower pharmacist-led personalized medicine have been suggested, which include the education, informatics, policy development, research, and ethical oversight. This review underlines the crucial role of clinical pharmacists in moving personalized medicine from the theoretical realm to day-to-day clinical practice.