Table 3. . CONQUal summary of findings.

	Synthesized findings	Type of research	Dependability	Credibility	CONQual score
Knowledge	If pharmacogenomic knowledge, awareness and engagement of primary care professionals can be improved through effective undergraduate and postgraduate education programs and if patients are appropriately engaged with the process, then primary care pharmacogenomic testing uptake is likely to increase.	Qualitative	Moderate	Equivocal	Moderate
Social and professional roles	Better engagement with pharmacogenomics testing can be achieved if there is a clear division of responsibility between Primary Care Professionals – GPs making the diagnosis and the pharmacist choosing the appropriate drug through use of pharmacogenomics testing. If a more comprehensive model for GP–pharmacist responsibility and engagement with patients is developed, then this could improve the uptake of pharmacogenomics testing in primary care. Furthermore, the process can be facilitated by a committee of local pharmacogenomics experts to guide decision making.	Qualitative	Moderate	Equivocal	Moderate
Behavioral regulation	If learning about the potential benefits and limitations of pharmacogenomics testing is made clearer for Primary Care Professionals and if patient expectations are managed effectively, then the benefits of pharmacogenomics testing in primary care can be more easily realized.	Qualitative	Moderate	Equivocal	Moderate
	If there is greater awareness and understanding between Primary Care Professionals that pharmacogenomics testing is complimentary rather than a substitute for current clinical decision-making, then this will increase their confidence and competence in using pharmacogenomics testing in primary care.	Qualitative	Moderate	Unequivocal	Moderate
Beliefs about consequences	If patients and Primary Care Professionals recognized the potential for pharmacogenomics testing to reduce adverse drug reactions and trial-and-error aspect of prescribing, then this will facilitate the uptake of pharmacogenomics testing in primary care.	Qualitative	Moderate	Equivocal	Moderate
	If the perceived benefit for the use of pharmacogenomics among primary care patients is promoted, then this will facilitate the uptake of pharmacogenomics testing in primacy care.	Qualitative	Moderate	Equivocal	Moderate
Environmental context and resources	If pharmacogenomics results can be implemented and incorporated into the normal workflow patterns at the point of prescribing and if results are easily comprehensible, then uptake by Primary Care Professionals in primary care can be improved.	Qualitative	Moderate	Equivocal	Moderate
	If policy makers and commissioners invest in cost-effective models for pharmacogenomics testing (where the benefit of testing outweighs the cost of the test), then this will help minimize inequities between low and high socio-economic patient groups and facilitate the uptake of pharmacogenomics testing in primacy care.	Qualitative	Moderate	Equivocal	Moderate
	If pharmacogenomics test results, which offer valid and reliable information are used to aid decision-making during prescribing, then this will facilitate the uptake of pharmacogenomics testing in primary care.	Qualitative	Moderate	Unequivocal	Moderate
	If the infrastructure around pharmacogenomics testing is strengthened such that results can be accessed in a timely manner and a prompt alerts the clinician to the availability of the results, then the uptake of pharmacogenomics in primacy care can be increased.	Qualitative	Moderate	Unequivocal	Moderate
	If more specific guidance is produced for Primary Care Professionals, highlighting when pharmacogenomics testing is appropriate. For example, if guidelines were produced by national bodies such as NICE or MHRA, which build upon international guidance produced by CPIC or DPWG, then Primary Care Professionals would be reassured of the evidence base for pharmacogenomics recommendations, and this could lead to increase uptake of pharmacogenomics testing in primacy care.	Qualitative	Moderate	Equivocal	Moderate
	If Primary Care Professionals have successfully used pharmacogenomics or have personal experience of undertaking a pharmacogenomics test, then they are more likely to use pharmacogenomics testing for their patients in the future.	Qualitative	Moderate	Equivocal	Moderate
Social influences	One of the benefits of genetic information collated for pharmacogenomics testing is related to whether a person will be susceptible to adverse drug reactions or not. Reassurance that genetic information is kept confidential, and this would not adversely affect a person’s employment or insurance rights, then the patients are going to be more receptive to pharmacogenomics testing.	Qualitative	Moderate	Equivocal	Moderate

GP: General practitioner; PGx: Pharmacogenomics.