Barriers to Implementing Clinical Pharmacogenetics Testing in Sub-Saharan Africa. A Critical Review
Clinical research in high-income countries is increasingly demonstrating the cost- effectiveness of clinical pharmacogenetic (PGx) testing in reducing the incidence of adverse drug reactions and improving overall patient care. Medications are prescribed based on an individual’s genotype (pharmacogen...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-08-01
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| Series: | Pharmaceutics |
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| Online Access: | https://www.mdpi.com/1999-4923/12/9/809 |
| _version_ | 1797555597626834944 |
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| author | Emiliene B. Tata Melvin A. Ambele Michael S. Pepper |
| author_facet | Emiliene B. Tata Melvin A. Ambele Michael S. Pepper |
| author_sort | Emiliene B. Tata |
| collection | DOAJ |
| description | Clinical research in high-income countries is increasingly demonstrating the cost- effectiveness of clinical pharmacogenetic (PGx) testing in reducing the incidence of adverse drug reactions and improving overall patient care. Medications are prescribed based on an individual’s genotype (pharmacogenes), which underlies a specific phenotypic drug response. The advent of cost-effective high-throughput genotyping techniques coupled with the existence of Clinical Pharmacogenetics Implementation Consortium (CPIC) dosing guidelines for pharmacogenetic “actionable variants” have increased the clinical applicability of PGx testing. The implementation of clinical PGx testing in sub-Saharan African (SSA) countries can significantly improve health care delivery, considering the high incidence of communicable diseases, the increasing incidence of non-communicable diseases, and the high degree of genetic diversity in these populations. However, the implementation of PGx testing has been sluggish in SSA, prompting this review, the aim of which is to document the existing barriers. These include under-resourced clinical care logistics, a paucity of pharmacogenetics clinical trials, scientific and technical barriers to genotyping pharmacogene variants, and socio-cultural as well as ethical issues regarding health-care stakeholders, among other barriers. Investing in large-scale SSA PGx research and governance, establishing biobanks/bio-databases coupled with clinical electronic health systems, and encouraging the uptake of PGx knowledge by health-care stakeholders, will ensure the successful implementation of pharmacogenetically guided treatment in SSA. |
| first_indexed | 2024-03-10T16:49:45Z |
| format | Article |
| id | doaj.art-57f04e220df44d1ab993382ed9dfe22d |
| institution | Directory Open Access Journal |
| issn | 1999-4923 |
| language | English |
| last_indexed | 2024-03-10T16:49:45Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceutics |
| spelling | doaj.art-57f04e220df44d1ab993382ed9dfe22d2023-11-20T11:21:17ZengMDPI AGPharmaceutics1999-49232020-08-0112980910.3390/pharmaceutics12090809Barriers to Implementing Clinical Pharmacogenetics Testing in Sub-Saharan Africa. A Critical ReviewEmiliene B. Tata0Melvin A. Ambele1Michael S. Pepper2Institute for Cellular and Molecular Medicine, Department of Immunology, and South African Medical Research Council Extramural Unit for Stem Cell Research & Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South AfricaInstitute for Cellular and Molecular Medicine, Department of Immunology, and South African Medical Research Council Extramural Unit for Stem Cell Research & Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South AfricaInstitute for Cellular and Molecular Medicine, Department of Immunology, and South African Medical Research Council Extramural Unit for Stem Cell Research & Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South AfricaClinical research in high-income countries is increasingly demonstrating the cost- effectiveness of clinical pharmacogenetic (PGx) testing in reducing the incidence of adverse drug reactions and improving overall patient care. Medications are prescribed based on an individual’s genotype (pharmacogenes), which underlies a specific phenotypic drug response. The advent of cost-effective high-throughput genotyping techniques coupled with the existence of Clinical Pharmacogenetics Implementation Consortium (CPIC) dosing guidelines for pharmacogenetic “actionable variants” have increased the clinical applicability of PGx testing. The implementation of clinical PGx testing in sub-Saharan African (SSA) countries can significantly improve health care delivery, considering the high incidence of communicable diseases, the increasing incidence of non-communicable diseases, and the high degree of genetic diversity in these populations. However, the implementation of PGx testing has been sluggish in SSA, prompting this review, the aim of which is to document the existing barriers. These include under-resourced clinical care logistics, a paucity of pharmacogenetics clinical trials, scientific and technical barriers to genotyping pharmacogene variants, and socio-cultural as well as ethical issues regarding health-care stakeholders, among other barriers. Investing in large-scale SSA PGx research and governance, establishing biobanks/bio-databases coupled with clinical electronic health systems, and encouraging the uptake of PGx knowledge by health-care stakeholders, will ensure the successful implementation of pharmacogenetically guided treatment in SSA.https://www.mdpi.com/1999-4923/12/9/809clinical pharmacogeneticspharmacogenetic testingadverse drug reactionsgenotypephenotypepharmacogene |
| spellingShingle | Emiliene B. Tata Melvin A. Ambele Michael S. Pepper Barriers to Implementing Clinical Pharmacogenetics Testing in Sub-Saharan Africa. A Critical Review Pharmaceutics clinical pharmacogenetics pharmacogenetic testing adverse drug reactions genotype phenotype pharmacogene |
| title | Barriers to Implementing Clinical Pharmacogenetics Testing in Sub-Saharan Africa. A Critical Review |
| title_full | Barriers to Implementing Clinical Pharmacogenetics Testing in Sub-Saharan Africa. A Critical Review |
| title_fullStr | Barriers to Implementing Clinical Pharmacogenetics Testing in Sub-Saharan Africa. A Critical Review |
| title_full_unstemmed | Barriers to Implementing Clinical Pharmacogenetics Testing in Sub-Saharan Africa. A Critical Review |
| title_short | Barriers to Implementing Clinical Pharmacogenetics Testing in Sub-Saharan Africa. A Critical Review |
| title_sort | barriers to implementing clinical pharmacogenetics testing in sub saharan africa a critical review |
| topic | clinical pharmacogenetics pharmacogenetic testing adverse drug reactions genotype phenotype pharmacogene |
| url | https://www.mdpi.com/1999-4923/12/9/809 |
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