Integrating pharmacogenomics into pain control pathways in the supportive care / palliative care setting: A Scoping Review Protocol

Objective: What implementation models for PGx have been studied with the intent to improve symptom management in supportive and palliative care? We aim to understand the extent and type of evidence in relation to the use of pharmacogenomic testing (PGx) in Palliative Care patients, with specific reference to improved pain control in this patient group.
Introduction: Pharmacogenomics has been an area of expanding research over the last 20 years, with several novel case uses that have been adopted as best practice in some countries (e.g. risk stratifying ototoxicity from future gentamicin usage in cystic fibrosis cohorts). The correct choice of pain relief at end of life is critically important to get right quickly, with many analgesic choices being susceptible to candidate pharmacogenomic testing, this could be an exemplar pathway for introducing PGx into medical practice.
Inclusion criteria: Research publications of studies in humans in the setting of a Palliative care department, that utilise a pharmacogenomic test, or survey for the presence of medicines susceptible to pharmacogenomic testing, to improve symptom control outcomes.
Methods: We will conduct a search of 6 databases, namely Ovid Embase, Medline, Ovid Emcare, CINAHL, ADEM and PsycInfo, up to July 2024 Using the key words below, plus the phrase “test” or “pilot” or “implementation”, to restrict results to primary research, rather than reviews or meta-analyses, if the primary search exceeds one thousand results. We will use reference snowballing from review articles and screened papers from the above search to identify any missed articles.