Pharmacogenomics in the Curricula of Colleges and Schools of Pharmacy in the United States

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INTRODUCTION

Two policy resolutions passed by the 2008 American Association of Colleges of Pharmacy (AACP) House of Delegates recommended increased focus on the advancement of education in biotechnology. The first pertained to the curricular implications of biotechnology and personalized medicine. It focused on the responsibility of pharmacy curricula to address up-to-date issues associated with biotechnology advances in tailored medicine. (1) Specific competencies discussed in this policy are cell and system biology, bioengineering, genetics/genomics, proteomics, nanotechnology, cellular and tissue engineering, bio-imaging, computational methods, and information technologies. The second policy pertained to faculty development in biotechnology areas. This policy stated that "faculty development programs and collaborative research and teaching strategies should be expanded such that faculty at colleges and schools of pharmacy are prepared to lead and contribute significantly to education and research ..." in the above areas.

Though colleges and schools of pharmacy (hereafter colleges of pharmacy) are likely working to address the educational needs surrounding the emergence of pharmacogenomics and other biotechnology areas, it appears that AACP members believed policy resolutions might ensure preparation of pharmacy students and faculty members for future roles in the application of biotechnology and pharmacogenomics to patient care. Determining how many colleges of pharmacy already meet the intent or have systems in place to implement these resolutions would provide valuable data for longitudinal assessment of these issues.

Prior to June 2004, Latif and McKay evaluated the depth and extent to which pharmacogenetics and pharmacogenomics content (hereafter referred to as pharmacogenomics) was being taught in colleges of pharmacy in the United States. (2) Their investigation was initiated as a result of the Core Competencies in Genetics Essential for all Health-Care Professionals document distributed by the National Coalition for Health Professionals Education in Genetics (NCHPEG) and recommendations from the 2001-2002 AACP Academic Affairs Committee. (3,4) The AACP Committee identified the need to include pharmacogenomics content in pharmacy curricula "because most drug effects are determined by the interplay of several gene products that govern the pharmacokinetics and pharmacodynamics of medication." (3) The committee believed that pharmacogenomics would change the practice of pharmacy by using a patient's genotype to guide dosing decisions in order to potentially improve medication effectiveness while reducing toxicity. Latif and McKay's investigation concluded that there was awareness of the need to increase the level of instruction in these areas among the colleges of pharmacy. (2)

The progress of pharmacogenomics and other biotechnology areas of inquiry over the last 40 years highlight the growing importance of the AACP resolutions. In the 1970s, Robert Smith's work with debrisoquine and Michel Eichelbaum's work with sparteine led to the discovery of a CYP2D6 genetic polymorphism, the frequency of which was enough to make it relevant to the general population and the use of a variety of drugs. (5) Over the next decade, drug response was recognized to often be determined by multiple genes as well as other factors. This new information led the focus from pharmacogenetics, the effect of a single gene on drug therapy, to the broader subject of pharmacogenomics, drug treatment based on the effects of many genes. (6) The evolution in focus to understand the entire genetic makeup of humans helped lead to the Human Genome Project (HGP). (7)

Initiated in 1990, the HGP set out to map the entire human genome to gain information regarding the "structure, organization and characteristics of human DNA." (8) The knowledge gained from the HGP has helped to identify individuals and families at risk for disease and can be used to ease the burden of diagnosis and treatments for various diseases. …