Advancing Clinical Practice with Pharmacogenomic-Guided Prescribing

Pharmacogenomics explores how an individual's genetic makeup influences their response to various medications. Integrating this genetic information into routine clinical prescribing has the potential to significantly improve patient outcomes and reduce healthcare costs. While generating genomic data in laboratories is relatively straightforward, a major challenge has been delivering this information to frontline healthcare providers in a timely and clinically relevant manner. This limitation has restricted the benefits of personalized medicine to only a select number of patients.

At the European Society of Human Genetics congress in 2025, Dr. John McDermott from the University of Manchester presented an innovative approach to overcome these challenges. His team, part of the NHS-England Network of Excellence for Pharmacogenomics & Medicines Optimization, has developed a system that seamlessly integrates genomic data into electronic health records (EHRs) used in both general practitioner (GP) practices and hospitals. This integration allows clinicians to access genetic information in their usual workflows, improving decision-making for medication choices.

The pharmacogenomic data can be used to select the safest and most effective drugs for individual patients, regardless of where they receive care. Unlike genetic testing for rare diseases or cancer, pharmacogenomics is relevant throughout a patient's life, influencing treatment decisions at multiple points. However, many healthcare professionals lack extensive training in interpreting complex genetic data.

To address this, the team developed a sophisticated informatic solution that presents genomic insights directly within existing EHR platforms. Dr. McDermott explained, “Our system works with many genetic testing platforms and major EHR systems worldwide, providing contextualized guidance without disrupting standard clinical workflows.”

Their PROGRESS program recruited patients from 20 sites across England, focusing on common medications such as statins, opioids, antidepressants, and proton pump inhibitors. The genetic guidance was incorporated into the patients’ electronic health records, enabling real-time decision support. An interim analysis involving 500 patients revealed that blast guidance was delivered to all, with a median processing time of seven days. Notably, 95% of participants had actionable genetic variants, leading to medication adjustments in over 25% of cases to enhance safety or efficacy.

Economic evaluations underscore the value of such interventions. For example, the UK's NICE recommends pharmacogenomic testing for stroke or TIA patients to optimize antiplatelet therapy, which has shown to prevent strokes and improve quality of life substantially.

Looking ahead, the researchers aim to leverage routinely collected healthcare data to assess the long-term impact of pharmacogenomic-guided prescribing on healthcare utilization and costs. Dr. McDermott emphasized that the high acceptance rate among clinicians reflects the system's resemblance to existing biomarker-based decisions, like renal function tests.

Prominent voices in the healthcare community, including NHS Chief Scientific Officer Professor Dame Sue Hill, highlighted the significance of these advancements in personalized medicine. She pointed out that over a quarter of study participants had their prescriptions changed to safer or more effective options, demonstrating the profound impact of integrating genomic insights into routine care.

This pioneering work signifies a major step towards making pharmacogenomics a standard component of patient care, promising improved treatment precision and better health outcomes for all.