RESUMEN
Background: Clopidogrel is a CYP2C19-activated pro-drug, used to prevent cardiovascular events. Up to 27% of Caucasians has at least one CYP2C19*2 allele (impaired enzymatic activity), whereas 38% have at least one CYP2C19*17 allele (higher enzymatic activity). However, CYP2C19 pharmacogenetic analysis before prescribing clopidogrel is not widely implemented in clinical practice. Purpose(s): To evaluate feasibility and operability of a collaborative pilot circuit to determine pharmacogenetic markers to optimise clopidogrel prescription. Method(s): The authors expect 150 patients with a clopidogrel prescription by a cardiologist of Hospital de Sant Pau to enrol. They can enrol when filling their prescriptions in one of the 24 collaborating community pharmacies in the Hospital's area. Community pharmacists collect from each participant's pharmacotherapeutic profile and a saliva sample to be sent to the hospital for CYP2C19 genotyping. Hospital pharmacists collate all obtained data with their clinical records. Data are analysed jointly with a cardiologist to assess clopidogrel prescription adequacy. Barcelona Pharmacists' Association (COFB) coordinates the whole project and provides IT and logistic support. Result(s): This project started in January 2020 and it was temporarily suspended due to the COVID19 pandemic. On 13th March 2020, 114 patients with clopidogrel prescriptions were registered, 21 met the inclusion criteria and 15 were enrolled. Five out of the eight already genotyped patients were intermediate or poor metabolisers. Conclusion(s): This circuit seems to be feasible, but further research is needed once the study is resumed. Pharmacogenetics increasing clinical relevance needs more clinical implication of pharmacists.