Table 3.

Barriers for implementing PGx testing in older adults with polypharmacy in routine clinical care

Barrier	How to address
Limited number of certified PGx facilities	Create a comprehensive public resource of certified facilities that is maintained and curated by designated academic centers and industry
Lack of provider knowledge	Develop online CME courses and training tools
Complexity of PGx testing results	Introduce evidence-based clinical pathways
Uncertainty in interpretation of PGx results	Create and maintain evidence-based consensus guidelines
Lack of clinical evidence on using PGx results	Conduct clinical trials demonstrating clinical efficacy
EMR does not support PGx result storage and review	Develop informatics solutions for storage, representation, and secure exchange of PGx data
Lack of computerized decision support	Introduce intelligent decision support allowing to account simultaneously for multiple drug–gene and drug–drug interactions and assist in medication regimen optimization
Lack of patient education	Develop interactive apps to support patient engagement in medication management and facilitate patient–provider communication on PGx testing

Abbreviations: PGx, pharmacogenomic; CME, continuing medical education; EMR, electronic medical record.