HN Summary

•Pharmacogenomics (PGx) and Testing: PGx studies how an individual’s genes affect their response to medications, influencing effectiveness and risk of side effects. PGx testing can guide healthcare providers in selecting personalized, safer, and more effective drug therapies.

•Canadian Pharmacists’ Perspectives: Studies across provinces (BC, Quebec, Manitoba, Ontario) show pharmacists support PGx integration into practice, recognizing its value in improving patient care. However, they emphasize the need for more training, patient/provider education, access to testing facilities, and supportive practice environments.

•Implementation Needs and Future Outlook: Successful PGx adoption requires investment in professional training, interprofessional collaboration, systematic supports (e.g., funding, electronic records), and informed patient consent. Ongoing provincial initiatives highlight PGx’s growing role in advancing personalized medicine in Canada.

What is pharmacogenomics (PGx) testing?

A PGx test identifies how an individual’s genetic make-up might affect their response to drugs. It may help healthcare providers select personalized medications that are more effective and with potentially fewer side effects to their patients. It may also help reduce multiple attempts or trials to identify the best possible medication therapy for the patient. 

The rest of this article provides you with an overview of a selection of Canadian studies pertaining to pharmacists’ perspectives/experiences in providing PGx related clinical services and supporting personalized medication recommendations in patient care.

British Columbia

In 2023, a qualitative research study in British Columbia (https://pubmed.ncbi.nlm.nih.gov/36437757/) has shown the promising role that pharmacists could play in implementing PGx testing in clinical practice. This study involved individuals with experience in PGx testing for major depression, as well as a range of healthcare professionals that included pharmacists, physicians, and geneticists. Pharmacists’ knowledge of pharmacokinetics and pharmacodynamics was viewed as an asset in interpreting PGx test results and subsequently guiding therapeutic decisions. More healthcare professional education and patient education, in addition to improved access to testing facilities were mentioned as facilitators to support effective PGx testing/implementation in patient care.

Quebec

In 2020, two studies from Quebec (a Université Laval study (https://pubmed.ncbi.nlm.nih.gov/32180495/) and a Université de Montréal study (https://pubmed.ncbi.nlm.nih.gov/32077363/)) further revealed that pharmacists generally supported PGx integration into practice and recognized its potential for personalized medication regimens. Many pharmacists expressed a willingness to collaborate with patients and prescribers on PGx testing but recognized that adequate education and support are essential.

Manitoba

In 2024, a cross-sectional survey conducted in Manitoba (https://pubmed.ncbi.nlm.nih.gov/38506345/) contributed additional insights to Canadian pharmacists’ perspectives on PGx implementation. While most pharmacist participants acknowledged the potential of PGx to improve medication safety and reduce adverse drug reactions, they also expressed a desire for more training in PGx, which aligned with the interests/concerns expressed in the Quebec studies.

Ontario

In 2017, the ICANPIC study in Ontario (https://pubmed.ncbi.nlm.nih.gov/28689706/) demonstrated that community pharmacists could implement PGx screening as part of their clinical services. Through this clinical service, pharmacists identified and resolved drug therapy problems for patients, through recommendation of medication therapy changes, dosage adjustments, and/or increased monitoring of medication therapy accordingly. A patient might benefit from PGx testing when they experienced ineffective therapy, adverse drug reactions, or initiated new drug therapy. Interprofessional collaboration with prescribers would facilitate the execution of pharmacists’ recommendations on safe and effective medication therapy.

In 2021, the Pharmacists as Personalized Medicine Experts (PRIME) study in Ontario (https://pubmed.ncbi.nlm.nih.gov/34941633/) also identified factors that would support the integration of PGx testing in primary care practices. Aside from healthcare professional training on PGx, supportive practice environments, such as electronic medical records, pre-visit questionnaires, reimbursement programs and/or funding were all considered as facilitators for integrating PGx in patient care.

Going Forward

PGx has the potential to improve medication safety and effectiveness through personalized medication therapy. Despite the potential benefits of PGx testing, it is important for patients to consult their healthcare provider before accessing PGx testing, to consider all available interventions/options for their medical condition(s), and to understand the risks and benefits associated with each intervention/option. 

At the same time, note that there are still current needs/considerations for, but not limited to, the following:

• More patient education and healthcare professional training on PGx and PGx testing

• Better understanding of how PGx testing can be incorporated/integrated to support patient care

• An awareness of healthcare coverage/funding (or not) and federal/provincial regulatory processes for PGx testing

• The importance of informed patient consent for PGx testing

Multiple Canadian studies have shown that investment in structured training programs for healthcare professionals, interprofessional collaboration, and systematic support are essential for validating the role and considerations of PGx in safe medication use and practices.

In August 2025, the Precision Medicine and Genetics Services Therapeutic Assessment and Access Branch, Health System Policy and Oversight Division, Ministry of Health in British Columbia, released a document titled “Pharmacogenomics Testing: Guidance for Patients” (https://www2.gov.bc.ca/assets/gov/health/health-drug-coverage/pharmacare/pgx_testing_policy_for_patients.pdf), providing an overview of PGx testing and considerations for incorporating PGx testing into health care decisions. Readers are encouraged to review this for further information.

By Aaron Nguyen and Certina Ho