Role of the genetic counselor in pharmacogenomic precision medicine

Genetic counselors are healthcare professionals with specialized education in medical genetics and psychosocial counseling who provide personalized care so that patients can make informed decisions about their genetic health. There is considerable overlap between clinical realms of patient education for pharmacogenomics and genetic counseling practice; however, the role of genetic counselors in pharmacogenomics, and specifically in development of clinical decision support, remains unclear. This chapter reviews foundational concepts of genetic counseling as they relate to pharmacogenomic testing, including discussion of positive, negative, and uncertain test results. This chapter summarizes concerns for discrimination, diversity, and inclusion with pharmacogenomics from the historical perspective of genetic counseling and reviews evidence supporting collaboration between clinical pharmacists and genetic counselors in practice. Additional information on diversity and inclusion is provided in Chapter 4, “Ensuring Equity and Access to Pharmacogenomic Clinical Decision Support,” while recommendations for integrating patient education into clinical decision support are reviewed in Chapter 9, “Patient-Facing Clinical Decision Support for Pharmacogenomic Precision Medicine.”