Pharmacogenomics Clinical Decision Support Systems

Pharmacogenomics is the study of genome-by-drug interactions. Pharmacogenomics challenges the traditional one-size-fits-all treatment paradigm, and aims to understand the mechanisms of person-to-person and between-population differences in drug efficacy and safety so as to deliver individually-tailored therapeutics.

Pharmacogenomics emerged from its predecessor field of pharmacogenetics. That genetics contributes not only to disease phenotypes but also drug response variability was the path-breaking idea that paved the way for pharmacogenetics more than 6 decades ago (Kalow, 1962; Motulsky, 1957). Friedrich Vogel of Heidelberg, Germany coined the term pharmacogenetics in 1959 while Werner Kalow wrote the first book on pharmacogenetics in Toronto a few years later (Kalow, 1962). With the advent of omics platforms and attendant high expectations from genomics in science and society in the late 1990s, pharmacogenetics became pharmacogenomics (Hedgecoe, 2003; Marshall, 1997). In the meantime, the precision/personalized medicine research agenda expanded from monogenic to multigenic drug-related phenotypes (Kalow et al. 2001; Ozdemir et al. 2005).

For the past 3 decades, the question “why is clinical uptake of pharmacogenomics slow?” has been on the public agenda ever since the high-throughput omics technologies became available at scale. The uptake of pharmacogenomics around the world is a complex task with multifactorial determinants. Moreover, individually-tailored precision medicines require customization within the local context of each country and community culture. Clinical Decision Support Systems (CDSSs) are health information technologies deployed to facilitate decision-making in the above complex socio-technical terrain of pharmacogenomics implementation science. In a systematic review in the September issue of OMICS, Anastasia Farmaki and colleagues suggest that digital health tools such as CDSSs can help accelerate pharmacogenomics clinical uptake worldwide. Furthermore, they examine and map the pharmacogenomics-CDSSs, noting that most of these initiatives have been deployed in the United States.

Pharmacogenetics has left its impressions in the sands of time since the mid-20th century while pharmacogenomics continues to harbinger the changing times in precision/personalized medicine today with the availability of CDSSs and digital health (Lin and Wu, 2022).

I welcome your manuscripts on pharmacogenomics-CDSSs and health informatics innovations in systems science for peer-review in the journal.