PRSB launches new work on pharmacogenomics

Genomics – the study of our genetic makeup – is increasingly transforming healthcare. Already genomics is helping to determine our individual risk of developing a number of diseases, detecting illness earlier, helping provide accurate diagnoses, and determining the most effective interventions to help improve our health.

Our genetic makeup also influences what medicines work best for us or should be avoided. The safe and effective prescribing of medicines tailored to an individual’s genetic makeup is known as pharmacogenomics and the NHS is keen to ensure that this information is communicated in the right way to the people that need to see it.

Research on current data shows that in a high volume (85%) of genomic records, there are findings which could be used to deliver better and safer prescribing of drugs. For example, certain information about a person’s genomic makeup could indicate which drugs might cause harm or be ineffective.

At present, the approach to drug development assumes that all patients with a particular condition respond similarly to a given drug. All patients with the same condition receive the same first line treatment even though it may be only 30 to 60% effective. Notifying prescribers of this information would mean that alternative drugs could be prescribed or an alert about the dose could be shared in order to reduce the potential harmful effects of drugs.

NHS England is currently exploring how this information can be used to improve the safety and quality of care. To inform this work PRSB has been asked to develop guidance on what information should be shared, with whom and when to support those who are prescribing medications.

The guidance will be developed with the support of experts and specialists across a broad range of services, as well as patients who are impacted. A focus group will be held in November to gain a wide range of opinions on what needs to be included in the guidance.

“If someone’s been working for a period of time, in a form of therapy, for instance, where there’s an agreed plan for the locality when they may present in an emergency situation … then it’s really important for us to be able to see that that information and be able to act appropriately according to that because, you know, there isn’t and there shouldn’t be a stock response to that. These plans are designed to be individualised and personalised.  All services should be giving that personalised approach to care wherever possible. And a standard such as [PCSP standard] definitely moves us closer towards being able to do that. [Not acting on agreed plans] is a key finding in terms of emergency responses over the years where responses have been inappropriate.” – Mental Health Nurse

“Following a particular plan that’s been put into place will result in much better outcomes and prevent the sort of poor outcome which would otherwise be leading to an unplanned hospital admission.” – General Practitioner