Two of the largest health systems in Florida have partnered to deliver pharmacogenomics services to pediatric patients across the state. Nemours Children’s Health and the University of Florida College of Pharmacy, a part of UF Health, are jointly employing a team of pharmacists to provide pharmacogenomic testing and consultation services.
The shared responsibility model offers a groundbreaking approach to health care, where UF pharmacists specially trained
in pharmacogenomics are helping Nemours Children’s patients better manage their medications.
UF College of Pharmacy Clinical Assistant Professors Kelsey Cook, Pharm.D., BCPS, and Nathan Seligson, Pharm.D., lead the clinical pharmacogenomics service at Nemours Children’s. Based in Jacksonville, the pair consults remotely with physicians and patients throughout Florida. Additionally, they undertake many traditional faculty responsibilities by teaching pharmacy students, engaging in research and participating in college activities.
“The opportunity to work in two different spaces is very unique,” Seligson said. “We have been fortunate to build a clinical and research program that not only serves patients but also students and trainees.”
Tailored treatments transform health care
As clinical pharmacists, Cook and Seligson work with the Nemours Children’s health care teams to determine if pharmacogenomic testing is appropriate for a patient. Pharmacogenomic testing involves analyzing an individual’s genetic makeup to predict how they may respond to specific
medications. Assessing genetic variations can help tailor drug choices and dosages as well as optimize treatments and minimize potential adverse effects.
If pharmacogenomic testing could benefit a patient, Cook and Seligson meet with the family to educate them on the process. They will work with the patient’s provider to order a lab test. They then analyze the results and schedule a consultation with the family.
Nearly all the consultations take place over the phone — a convenience many patients enjoy.
“The service was designed during the height of the COVID-19 pandemic, and it has worked really well to offer our pharmacogenomic
consultations remotely,” Cook said. “Parents appreciate having the test kit mailed to their home and not having to come into the clinic to review the results.”
Cook and Seligson work closely with the patient’s physician in determining any treatment recommendations. They support pharmacogenomic testing for about 85 pediatric patients a year. Many parents seek the testing to better manage their child’s psychiatric or pain medications.
“Patients and their families are so appreciative of having the pharmacogenomic test results, especially if we identify a medication recommendation that may improve their health and quality of life,” Cook said. “Many patients receive normal test results, which gives them peace of mind. It also offers us a valuable opportunity to provide them with general education about pharmacogenomics.”
Cook and Seligson also provide pharmacogenomic services through two major research studies. The ADOPT PGx clinical trial has recruited over 100 participants and aims to assess the influence of pharmacogenomic testing and genotype-guided antidepressant therapy on depression symptoms. A second study has enrolled more than 60 patients and is examining the impact of pharmacogenomics on hydrocodone response for patients with sickle cell disease.
Nemours Children’s Health serves as an affiliate site for these UF-led research studies, illustrating another instance of collaboration between these health care providers in the realm of pharmacogenomics.
“Partnering with a premier pediatric health care provider in Nemours Children’s Health allows the UF College of Pharmacy to collaborate across all of our core missions, including research, education, and clinical services,” said John Gums, Pharm.D., FCCP, executive associate dean in the UF College of Pharmacy. “Our college brings an international reputation in pharmacogenetics and research to the patient care experience at Nemours Children’s. In return, they provide the UF College of Pharmacy access to nationally recognized providers and clinicians in a collaborative environment that ultimately improves the overall care that patients receive.”
A national leader in pharmacogenomics
UF has established one of the nation’s top training programs in pharmacogenomics. A graduate certificate and master’s degree are offered as well as a postgraduate year two, or PGY2, clinical pharmacogenomics residency and multiple fellowship programs. In addition, pharmacogenomics is integrated into the UF College of Pharmacy’s Pharm.D. curriculum and students can earn a certificate in personalized medicine.
Cook and Seligson were both involved in UF’s training programs before accepting their faculty roles in 2019. Cook completed the PGY2 clinical pharmacogenomics residency and provided clinical consultations for UF Health patients involved with pharmacogenomic testing. Seligson participated in a six-week pharmacogenomics rotation with the UF Precision Medicine Program while attending pharmacy school at the University of South Florida.
These training experiences inspired their path into academic pharmacy. As faculty, they are imparting their knowledge and expertise to the students and trainees who are following in their footsteps.
“We supervise fourth-year UF pharmacy students on their advanced pharmacy practice experiences rotations and work
with UF fellows and pharmacy residents,” Seligson said. “Our location in Jacksonville also allows us to work with pharmacy residents from other hospitals who are interested in pharmacogenomics.”
Whether it’s through patient consultations, research or training students, Cook and Seligson are paving the way for pharmacogenomics to play a more prominent role in health care. In doing so, they are uniting two of the state’s largest health care providers in the quest for more personalized medicine.
