Pharmacogenomics
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African-Americans are under-represented in studies assessing contributors to warfarin response. Our primary objective was to determine whether the genes for cytochrome P450 (CYP) 2C9, nicotinamide adenine dinucleotide phosphate, reduced, quinone oxidoreductase (NQO1) and vitamin K epoxide reductase complex subunit 1 (VKORC1) are associated with warfarin dose requirements in African-Americans. ⋯ Our data suggest that CYP2C9 genotype, age and body size are important determinants of warfarin dose requirements in African-Americans. Our data further suggest that the VKORC1 G6853C polymorphism alone may not be useful for predicting warfarin dose requirements in this racial group.
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There is limited empirical evidence on patients' and healthcare professionals' views on the provision of pharmacogenetic testing services. These opinions may be used to shape the development of emerging pharmacogenetic services and inform healthcare professionals' future educational requirements. ⋯ There is no clear model of how pharmacogenetic tests will be delivered in clinical practice. Patients expect to receive pharmacogenetic services from healthcare professionals who are able to explain the test, and interpret the implications for prescribing, with confidence. The gap between patients' high expectations for information and healthcare professionals' current knowledge and reluctance to deliver pharmacogenetic services highlights the urgent need for better education and training of healthcare professionals in pharmacogenetics.