Implementation of Pharmacogenomics in Pediatric‐Focused Institutions Within the Pharmacogenomics Global Research Network

Descriptions of how pediatric-focused institutions implement pharmacogenomic testing are scarce, and often not differentiated from adult-focused institutions. We aimed to provide a detailed description of how pediatric-focused institutions across the world implemented pharmacogenomic testing in clinical practice. A survey was distributed to members of the Pharmacogenomics Global Research Network to assess program infrastructure, implementation efforts, genes tested, method of testing, and clinical decision support. The survey was completed by 43 institutions that have implemented pharmacogenomics: 12 pediatric-focused, 10 adult-focused, and 21 institutions serving all ages. All pediatric-focused institutions provide testing for CYP2C19, CYP2C9, CYP2D6, CYP3A5, NUDT15, and TPMT. Psychiatry and hematology/oncology were the specialties most commonly reported as implementing pharmacogenomics at pediatric-focused institutions. Most institutions have clinical decision support incorporated into their electronic health record and a similar number of compensated employees contributing to the program, regardless of age group focus. All pediatric-focused institutions were non-profit and often received programmatic funding from internal sources. A higher proportion of pediatric-focused sites provided patient education (92%) compared to adult-focused (60%) and those caring for all ages (76%). Pediatric-focused institutions interested in implementing or expanding their pharmacogenomic services will encounter many of the same opportunities and considerations as adult institutions. The results of this survey highlight additional unique considerations for pediatric-focused pharmacogenomic implementation and may serve as a roadmap for pediatric institutions interested in implementing or expanding pharmacogenomic services.