Current knowledge and use of pharmacogenomics among NPs

BACKGROUND: Pharmacogenomics, a critical component of precision medicine, is rapidly transforming health care by tailoring drug therapy based on individual genetic profiles. Nurse practitioners (NPs), as frontline providers and prescribers, play a key role in implementing pharmacogenomics into clinical practice. Despite its growing importance, limited research has examined NPs' current knowledge about and use of pharmacogenomics in clinical practice. METHODS: An integrative review was conducted using Whittemore and Knafl's methodology. Literature searches were performed across six databases using defined search terms related to NPs and pharmacogenomics. Peer-reviewed articles published between January 2020 and March 2025 were included. Studies were screened based on inclusion criteria, critically appraised using Joanna Briggs Institute checklists, and thematically analyzed. Ten articles were included: eight quantitative, one qualitative, and one mixed-methods. RESULTS: Five key themes emerged: (1) technology supports, including mobile apps and decision support tools; (2) education, highlighting gaps in formal genomics training; (3) specialty application, showing varied implementation across NP specialities; (4) knowledge to implementation, focusing on the space between NP pharmacogenomics learning, application of knowledge, and use of testing in clinical practice; and (5) barriers and resistance to pharmacogenomic use, including challenges such as knowledge deficits, cost, and NP perception of the value of pharmacogenomics. CONCLUSION: Despite positive attitudes toward pharmacogenomics, significant barriers hinder its integration into NP-led care. Formal education and continuing education around pharmacogenomics and supportive infrastructure, including funding, are essential to increase NP uptake and integration of pharmacogenomics into patient care. In addition, introductory material should be integrated into NP program curricula. Future research should focus on learning outcomes and the application of pharmacogenomics before and after participating in learning within graduate-level NP education programs and continuing-education programs for those already in practice.