Genomics Laboratory, A Multidisciplinary Team Driving Patient-Centered Precision Medicine
In the previous Special Scoop, we introduced the Genomics Laboratory at MedPark Hospital and explored the potential of modern medical genetics. In this edition, let us explore the vital roles that nurses and pharmacists play in advancing genetic medicine.
Managing Genetic Disorders Requires a Multidisciplinary Team
In the previous article, Dr. Nok – Asst. Prof. Dr. Tanawan Samleerat Carraway, Genomics Laboratory Manager, shared how the Genomics Lab at MedPark integrates expertise across disciplines to ensure that clinicians can apply genetic testing results to diagnose and plan disease treatment.
“Our team encompasses beyond medical technologists and clinical geneticists. We also have specially trained genetic nurse counselors who take patient histories and communicate genetic information in a way that patients and families can easily understand. Moreover, pharmacists play a key role in applying genetic test results to guide the selection of medications tailored to the unique genetic profile of each individual.”
In their role, nurses do much more than coordinate with hospital staff. They serve as frontline staff, directly interacting and communicating with patients. Miss Rattavanun Ninpetchaikoon, a genetic nurse counselor, shares insights about the work of a genetic nurse.
Understanding the Role of a Genetic Nurse: Collecting Data, Assessing, and Providing Genetic Counseling
Nurses screen and assess patients before they go to see the doctors. However, when serving as a genetic nurse, there are specialized areas of knowledge that the genetic nurse must understand in depth to provide preliminary genetic guidance and support to patients.
“When providing counseling to couples planning a pregnancy, nurses serve as the first point of contact to take medical histories and screen for potential genetic risks in both partners. One of the primary genetic conditions screened for is thalassemia. If detected, there are varying levels of risk to the child. Detailed testing helps assess the situation and determine the best course of action, illustrating how medical science can support and guide the couple step-by-step through the pregnancy planning process.”
Cancer is another disease where medical genetics plays an important role. Nurses must possess the knowledge and skills to accurately collect patient and family histories and offer informed advice on the need for genetic screening, including whether other family members need screening as well.
“As nurses, it is essential for us to have a solid understanding of medical genetics so that we can effectively take patient histories and perform preliminary assessments. We also provide patients with important information they need to know. If further testing is necessary, we will inform them accordingly. If testing is not required but the patient has concerns, we guide them through the appropriate next steps.”
“We can also provide telephone consultations for patients who are anxious and uncertain about how to proceed. Ms. Som explained that nurses are pivotal in providing emotional support to patients and their families when the test results or the testing process affect their emotions.”
Additionally, nurses play a crucial role in screening patients’ medication and allergy history. They are responsible for monitoring blood test results, recording the data, and coordinating with pharmacists; therefore, pharmacists must accurately document information in the system and develop precise, appropriate, and safe medication plans tailored to each patient. This pharmaceutical expertise forms another crucial component of the Genomics Laboratory team.
Genetics Can Predict Drug Allergies and Medication Efficacy
The role of pharmacists in the Genomics Laboratory directly impacts patient safety. Some patients may be unaware of their allergies to certain medications and only discover them after experiencing an adverse reaction upon taking the drug. These reactions can range from mild to life-threatening, significantly affecting the patient’s well-being and daily life. We spoke with Miss Chanakarn Maneeratroj, a clinical pharmacology specialist, about the collaboration between the Genomics Laboratory and pharmacists to achieve the best possible outcomes for patients.
“Pharmacogenomic testing can screen for drug allergies among commonly used medications that may cause severe adverse reactions. Modern medical genetics can identify specific genes in the human body that signify a higher risk of severe allergic reactions to certain drug classes, allowing us to avoid the use of those medications and protect vulnerable patients from adverse effects.”
Severe drug allergies can manifest in various ways, ranging from rashes and widespread skin peeling to severe skin reactions resembling scald burns. In some cases, the condition may involve internal organs, leading to organ dysfunction, which necessitates costly and complex medical care, significantly reducing quality of life. If we can prevent such severe allergic reactions, the value would be immeasurable.
“Some drugs don’t trigger immediate allergic reactions within hours or days, but rather after several months. Which means the patient and the doctor may be unaware of the cause of the allergy, and the medication continues to be administered. As the drug accumulates in the body, the eventual reaction can be extremely severe. If we can identify the risk in advance, it can make a significant difference.”
Additionally, gene testing can reveal whether our bodies produce normal enzymes necessary to metabolize and absorb certain medications. If not, the drug may not work as intended, resulting in reduced or no therapeutic effect. Taking such a medication would therefore be ineffective.
“For example, antiplatelet drugs or stroke medications are expected to deliver specific therapeutic effects. If it is known in advance that a particular drug will not be fully effective in a patient, continuing its use not only fails to improve the patient’s condition but also leads to unnecessary expenses. With this information, doctors can consider alternative medications that will work as intended, ensuring the most effective treatment possible.”
Genomics Lab: The Future of Personalized Medicine
Dr. Nok encapsulates the essence of medical genetics by describing genomic testing as a gateway to personalized healthcare. It offers profound insights at the genetic level—insights unattainable through conventional health screenings. Among its most significant benefits is empowering individuals to develop precise strategies for managing their health and shaping their future.
“When patients become aware of their specific cancer risks, medications they should avoid, and medications that are most effective for them, they gain the power to tailor their healthcare with precision, saving time and preventing unnecessary ineffective or harmful medical costs.”
“Simply put, we are transitioning from an era of reactive healthcare—waiting until illness strikes before treating it—to a proactive approach where we can identify risks early, make plans in advance, and deliver precise, targeted treatments from the outset. This capability imparts a genuine and profound benefit for patients.”
