Figure 1.

Pharmacist journey per enrolled patient. Pharmacists invite patients who initiate one of the 39 drugs with a Dutch Pharmacogenetics Working Group (DPWG) recommendation. After informed consent, a DNA sample is collected and sent to the Leiden University Medical Center Pharmacogenetics Lab for a pharmacogenomics (PGx) panel test encompassing 12 pharmacogenes. Actionable test results for the drug of enrolment are directly communicated to the pharmacist by phone and email. Other PGx test results are communicated by email. The pharmacist is responsible for recording the PGx results in the electronic medical record (EMR). The pharmacist may choose whether to adhere to the DPWG recommendations. Approval of the treating physician is required before any changes to the drug treatment can be made. Following the report of an actionable PGx result, a PGx recommendation specific survey is performed. Pharmacists were invited for a semi-structured interview and general survey if they had managed at least two patients with actionable PGx results.